NewWorkers Comp Claims Adjuster - Contract - HYBRID JobotWorkers Comp Claims Adjuster - Contract - HYBRIDBasking Ridge, NJ$32–$36 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. This role is responsible for managing a caseload of workers’ compensation claims from inception through resolution, ensuring timely handling, regulatory compliance, and effective cost management.
Public Claims Adjuster Metro Public AdjustmentPublic Claims AdjusterNewark, NJ$50,000–$250,000 / yearFull timePart timeWe are seeking a motivated Outside Sales Representative to generate new business, build client relationships, and partner with our claims team. Experience in outside/territory sales, business development, or consultative selling; insurance/public adjusting experience a plus.
NewClaims Specialist Medical Malpractice Diedre Moire Corp.Claims Specialist Medical MalpracticePiscataway, 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.
Claims Processor - Work from Home Sagility LtdClaims Processor - Work from HomeNYp>job Details Job title Claims Processor - Work from Home About Sagility Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.
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.
Senior Claims Researcher Clover Health Investments CorpSenior Claims ResearcherNYRemote$107,000–$130,000 / yearp>Success 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.
Manager, Claim Processing CVS Health CorpManager, Claim ProcessingNY$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.
Senior 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.
Senior 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.
Senior 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.
Manager, Claims Amalgamated LifeManager, ClaimsWhite Plains, NYp>A Disability Claims Manager 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 Manager 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.
Director, Claims Amalgamated LifeDirector, ClaimsWhite Plains, New YorkOverview: A 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.
Claims Manager - Excess Casualty Claims AXIS Capital Holdings LtdClaims Manager - Excess Casualty ClaimsShort Hills, NJ$160,000–$190,000 / yearli>Close 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.
Claims Adjustment Specialist I Metroplus Health Plan IncClaims Adjustment Specialist INY$48,791–$50,593 / yearp>MetroPlusHealth 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.
Director, 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.
Claims 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.Life 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.Claims 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.Senior Claims Consultant, National Accounts Relation Insurance Services, IncSenior Claims Consultant, National AccountsNY$92,000–$154,000 / yearp>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. The Senior Claims Consultant, National Accounts serves as an advisor and primary claims resource for large, complex accounts through a range of internal and external resources.Claims Manager Normann StaffingClaims ManagerRye Brook, NY$70,000–$110,000 / yearSenior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistWork At Home, NY$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.Employee Benefits Claims Team Leader (HYBRID OR REMOTE) Equitable Financial Life Insurance CompanyEmployee Benefits Claims Team Leader (HYBRID OR REMOTE)NYRemote$68,000–$92,000 / year418318'',''true'',''418318'',''false'',''Submission for the position: Employee Benefits Claims Team Leader (HYBRID OR REMOTE) - (Job Number: 260000AW)'',''false'',''418318'',''false'',''true'',''Employee Benefits Claims Team Leader (HYBRID OR REMOTE)'',''260000AW'',''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'',''!*! Claims Management: Expertise in delivering a positive claims experience for Disability and/or Leave of Absence products, such as Short Term Disability, Statutory Disability Coverages, Long Term Disability, or State Paid Leaves.Claims 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.Executive 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.Business Analyst, Claims VNS HealthBusiness Analyst, ClaimsNew 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.NewClaims Processing Agent - Freelance AI Trainer MindriftClaims Processing Agent - Freelance AI TrainerQueens, NYp>While each project involves unique tasks, contributors may: Evaluate AI-generated auto insurance claims decisions for accuracy, coverage correctness, and regulatory compliance; Design FNOL scenarios with deliberate contradictions, decoy files, and outdated documents to test agent robustness; Write and grade fraud-flagging scenarios using structured reason codes (late reporting, recently purchased policy, inconsistent damage) for SIU referral; Build subrogation test cases applying state-specific negligence rules (comparative vs. Ideally, contributors will have: Degree in Insurance, Risk Management, Business Administration, Finance, Law, or any related field; 3+ years of insurance, claims, legal, or financial services experience; Current or recent experience in claims & adjusting or adjacent roles; Familiarity with auto insurance coverage decisions, state-specific negligence rules, and adjuster authority-limit culture; AIC, CPCU, CIFI, or SCLA credential is a strong positive signal, though not required if hands-on experience is solid; Strong written English (C1+).Claims Quality Analyst Metroplus Health Plan IncClaims Quality AnalystNY$55,000–$65,000 / yearp>About 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.HealthCare Claims Analyst Village CareHealthCare Claims AnalystNew York, NY$65,294.40–$72,277 / yearYou will play a critical role in understanding healthcare reimbursement from both financial and operational perspectives, conducting audits, and performing root cause analysis to resolve identified issues with internal teams and third-party administrators (TPAs). To excel as a Full-Time HealthCare Claims Analyst at VillageCare, candidates must possess a Bachelor's Degree in a relevant field such as Computer Science, Mathematics, Statistics, or Engineering, with a Master's degree preferred.Claims Specialist (Fidelity Lines) ( Remote ) ( Full-Time ) Career DevelopersClaims Specialist (Fidelity Lines) ( Remote ) ( Full-Time )Berkley Heights, NJRemote$145,000–$170,000 / yearRefer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. The role also evaluates claims for reserve and settlement, executes settlement strategy, negotiates settlements proactively, attends arbitrations, and ensures appropriate file documentation.NewCasualty Claims Adjuster II EMC Insurance Group Inc.Casualty Claims Adjuster IINY$60,813–$84,038 / yearBy collaborating cross-functionally and acting as a trusted partner to agents, vendors, and internal teams, you will play a critical role in reducing risk, controlling costs, and strengthening relationships while continuously elevating the quality and integrity of the claims process. Step into a role where your expertise directly drives meaningful outcomes, leveraging your investigative instincts, sound judgment, and negotiation skills to bring clarity and resolution to complex claims.Cyber Claims Advocate Marsh & McLennan Companies IncCyber Claims AdvocateNY$84,700–$180,300 / yearli>Liaises 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.Voluntary Benefits Claims Manager New York Life Insurance CoVoluntary Benefits Claims ManagerNYRemote$45,000–$70,000 / yearPerform multi-policy checks where appropriate to determine if New York Life claimants with active disability and/or Life claims may be eligible for additional VB benefits as a result of their condition(s) in support of GBS service integration initiatives. We provide a full package of benefits for employees and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs.NewClaims Examiner II Metroplus Health Plan IncClaims Examiner IINew York, NY$54,000–$64,474 / yearul>Bachelor's degree is required; a Master's degree is preferred, or an equivalent combination of education and relevant experience that demonstrates satisfactory equivalency. The ideal candidate will have experience processing healthcare claims in a high-volume Claims Department.Claims 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.Claims 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.Epic 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.Claims Supervisor Metroplus Health Plan IncClaims SupervisorNY$60,000–$70,000 / yearp>Required 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.Senior Claims Reviewer Railway Health IncSenior Claims ReviewerNY$75,000–$100,000 / yearWhat we are looking for5+ years of experience in medical or stop-loss claims review, audit, or adjudicationMeticulous, analytical, and detail-oriented - you take pride in accuracy and root-cause thinkingExperienced in identifying inappropriate billing, duplicate charges, and coding errors (ICD-10, CPT, HCPCS, DRG)Comfortable communicating with TPAs, providers, and internal stakeholders to resolve discrepanciesIn-depth understanding of plan design, coordination of benefits, subrogation, and provider billing practicesFamiliarity with fraud, waste, and abuse (FWA) detectionStrong working knowledge of claims processing systems and supporting tools (Excel, SQL, Python)Bachelor's degree or equivalent experience in healthcare administration, insurance, or a related field. High Impact: You'll be working cross-functionally with operations and our data science team and your work will be key to building a health insurance company from scratch (where else can you do that??) Fast-Growing Startup: Join us at an inflection point - we're scaling quickly and thoughtfully.Claims Intake Specilist Nesco Resource, LLCClaims Intake SpecilistNew York City, NY$33–$40 / hourp>Nesco 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.Health Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNY$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.Executive Claims Director Hamilton Insurance Group LtdExecutive Claims DirectorNew Jersey, NJExperience in handling severity and excess casualty claims or related litigation Experience working claims in the Excess and Surplus Market preferred Experience working with complex coverage issues required Multi-jurisdictional claims and litigation experience preferred Adjuster license and/or certifications preferred Highly advanced knowledge of claim processes, policies, procedures, claim systems, regulation, coverage, liability, damage evaluation, and/or settlement with exposures in excess of $1M Excellent at establishing close working relationships with other departments, including underwriting, operations, finance, IT, actuarial and legal Strong negotiating, analytical, written, and organizational skills Mediation and arbitration experience Strong computer skills (Microsoft Office Suite and in-house claims systems) Ability to prioritize and manage deadlines Ability to work both independently and collaboratively as part of a team Bachelor's degree required; JD preferred Excellent verbal and written communication skills Ability to analyze data and make sound judgments Ability to prioritize and manage deadlines Ability to work both independently and collaboratively as part of a team. Dedicated and hard-working Willingness to learn and apply concepts Able to work autonomously with strong organizational skills and the ability to plan ahead Keen attention to detail, highly analytical and excellent problem-solving capability Collaborative spirit Results-oriented, forward-thinking, and growth mindset.Senior 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.NewEmployee Benefits Head of Claims (HYBRID or REMOTE) Equitable Financial Life Insurance CompanyEmployee Benefits Head of Claims (HYBRID or REMOTE)NYRemote$360,000–$470,000 / yearp>''418883'',''true'',''418883'',''false'',''Submission for the position: Employee Benefits Head of Claims (HYBRID or REMOTE) - (Job Number: 260000C9)'',''false'',''418883'',''false'',''true'',''Employee Benefits Head of Claims (HYBRID or REMOTE)'',''260000C9'',''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'',''!*! Customer Experience Management: Knowledge of customer experience management; ability to implement strategies and techniques used to ensure that customers have a positive experience with the organization''s products and services at every touch point.Chief 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.Senior Casualty Claims Specialist – TPA Oversight Everest GroupSenior Casualty Claims Specialist – TPA OversightWarren, New Jerseydiv>Title: Senior Casualty Claims Specialist – TPA OversightCompany: Everest Insurance CompanyJob Category: ClaimsJob Description: About Everest:. Berg%40everestglobal.com%7C4684610f71aa4b91d22608dd662d95b5%7C0002cd247dd64542acd6e0c7e184c80c%7C0%7C0%7C638779068184154036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=YSL9XQs%2FJtn2nZcYoYaT1mmOhyI%2BUrByZFY%2FYaTj8Ns%3D&reserved=0" rel="nofollow noopener noreferrer" target="_blank">here to learn more about our culture.Claims Specialist II Everest GroupClaims Specialist IIWarren, New Jerseydiv>Title: Claims Specialist IICompany: Everest Insurance CompanyJob Category: ClaimsJob Description: About Everest: . Berg%40everestglobal.com%7C4684610f71aa4b91d22608dd662d95b5%7C0002cd247dd64542acd6e0c7e184c80c%7C0%7C0%7C638779068184154036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=YSL9XQs%2FJtn2nZcYoYaT1mmOhyI%2BUrByZFY%2FYaTj8Ns%3D&reserved=0" rel="nofollow noopener noreferrer" target="_blank">here to learn more about our culture.Senior 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.Private Client Claims Advocacy Leader Marsh & McLennan Companies IncPrivate Client Claims Advocacy LeaderNY$125,000–$233,000 / yearli>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. 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.Junior 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 / yearRefer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. Duties 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.Workers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY) NFP CorpWorkers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY)NY$40,000–$50,000 / yearWe help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location.12345678910Resume ResourcesFree Resume TemplatesFree Resume Builder
Life 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.
Claims 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.
Senior Claims Consultant, National Accounts Relation Insurance Services, IncSenior Claims Consultant, National AccountsNY$92,000–$154,000 / yearp>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. The Senior Claims Consultant, National Accounts serves as an advisor and primary claims resource for large, complex accounts through a range of internal and external resources.
Senior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistWork At Home, NY$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.
Employee Benefits Claims Team Leader (HYBRID OR REMOTE) Equitable Financial Life Insurance CompanyEmployee Benefits Claims Team Leader (HYBRID OR REMOTE)NYRemote$68,000–$92,000 / year418318'',''true'',''418318'',''false'',''Submission for the position: Employee Benefits Claims Team Leader (HYBRID OR REMOTE) - (Job Number: 260000AW)'',''false'',''418318'',''false'',''true'',''Employee Benefits Claims Team Leader (HYBRID OR REMOTE)'',''260000AW'',''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'',''!*! Claims Management: Expertise in delivering a positive claims experience for Disability and/or Leave of Absence products, such as Short Term Disability, Statutory Disability Coverages, Long Term Disability, or State Paid Leaves.
Claims 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.
Executive 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.
Business Analyst, Claims VNS HealthBusiness Analyst, ClaimsNew 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.
NewClaims Processing Agent - Freelance AI Trainer MindriftClaims Processing Agent - Freelance AI TrainerQueens, NYp>While each project involves unique tasks, contributors may: Evaluate AI-generated auto insurance claims decisions for accuracy, coverage correctness, and regulatory compliance; Design FNOL scenarios with deliberate contradictions, decoy files, and outdated documents to test agent robustness; Write and grade fraud-flagging scenarios using structured reason codes (late reporting, recently purchased policy, inconsistent damage) for SIU referral; Build subrogation test cases applying state-specific negligence rules (comparative vs. Ideally, contributors will have: Degree in Insurance, Risk Management, Business Administration, Finance, Law, or any related field; 3+ years of insurance, claims, legal, or financial services experience; Current or recent experience in claims & adjusting or adjacent roles; Familiarity with auto insurance coverage decisions, state-specific negligence rules, and adjuster authority-limit culture; AIC, CPCU, CIFI, or SCLA credential is a strong positive signal, though not required if hands-on experience is solid; Strong written English (C1+).
Claims Quality Analyst Metroplus Health Plan IncClaims Quality AnalystNY$55,000–$65,000 / yearp>About 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.
HealthCare Claims Analyst Village CareHealthCare Claims AnalystNew York, NY$65,294.40–$72,277 / yearYou will play a critical role in understanding healthcare reimbursement from both financial and operational perspectives, conducting audits, and performing root cause analysis to resolve identified issues with internal teams and third-party administrators (TPAs). To excel as a Full-Time HealthCare Claims Analyst at VillageCare, candidates must possess a Bachelor's Degree in a relevant field such as Computer Science, Mathematics, Statistics, or Engineering, with a Master's degree preferred.
Claims Specialist (Fidelity Lines) ( Remote ) ( Full-Time ) Career DevelopersClaims Specialist (Fidelity Lines) ( Remote ) ( Full-Time )Berkley Heights, NJRemote$145,000–$170,000 / yearRefer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. The role also evaluates claims for reserve and settlement, executes settlement strategy, negotiates settlements proactively, attends arbitrations, and ensures appropriate file documentation.NewCasualty Claims Adjuster II EMC Insurance Group Inc.Casualty Claims Adjuster IINY$60,813–$84,038 / yearBy collaborating cross-functionally and acting as a trusted partner to agents, vendors, and internal teams, you will play a critical role in reducing risk, controlling costs, and strengthening relationships while continuously elevating the quality and integrity of the claims process. Step into a role where your expertise directly drives meaningful outcomes, leveraging your investigative instincts, sound judgment, and negotiation skills to bring clarity and resolution to complex claims.Cyber Claims Advocate Marsh & McLennan Companies IncCyber Claims AdvocateNY$84,700–$180,300 / yearli>Liaises 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.Voluntary Benefits Claims Manager New York Life Insurance CoVoluntary Benefits Claims ManagerNYRemote$45,000–$70,000 / yearPerform multi-policy checks where appropriate to determine if New York Life claimants with active disability and/or Life claims may be eligible for additional VB benefits as a result of their condition(s) in support of GBS service integration initiatives. We provide a full package of benefits for employees and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs.NewClaims Examiner II Metroplus Health Plan IncClaims Examiner IINew York, NY$54,000–$64,474 / yearul>Bachelor's degree is required; a Master's degree is preferred, or an equivalent combination of education and relevant experience that demonstrates satisfactory equivalency. The ideal candidate will have experience processing healthcare claims in a high-volume Claims Department.Claims 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.Claims 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.Epic 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.Claims Supervisor Metroplus Health Plan IncClaims SupervisorNY$60,000–$70,000 / yearp>Required 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.Senior Claims Reviewer Railway Health IncSenior Claims ReviewerNY$75,000–$100,000 / yearWhat we are looking for5+ years of experience in medical or stop-loss claims review, audit, or adjudicationMeticulous, analytical, and detail-oriented - you take pride in accuracy and root-cause thinkingExperienced in identifying inappropriate billing, duplicate charges, and coding errors (ICD-10, CPT, HCPCS, DRG)Comfortable communicating with TPAs, providers, and internal stakeholders to resolve discrepanciesIn-depth understanding of plan design, coordination of benefits, subrogation, and provider billing practicesFamiliarity with fraud, waste, and abuse (FWA) detectionStrong working knowledge of claims processing systems and supporting tools (Excel, SQL, Python)Bachelor's degree or equivalent experience in healthcare administration, insurance, or a related field. High Impact: You'll be working cross-functionally with operations and our data science team and your work will be key to building a health insurance company from scratch (where else can you do that??) Fast-Growing Startup: Join us at an inflection point - we're scaling quickly and thoughtfully.Claims Intake Specilist Nesco Resource, LLCClaims Intake SpecilistNew York City, NY$33–$40 / hourp>Nesco 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.Health Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNY$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.Executive Claims Director Hamilton Insurance Group LtdExecutive Claims DirectorNew Jersey, NJExperience in handling severity and excess casualty claims or related litigation Experience working claims in the Excess and Surplus Market preferred Experience working with complex coverage issues required Multi-jurisdictional claims and litigation experience preferred Adjuster license and/or certifications preferred Highly advanced knowledge of claim processes, policies, procedures, claim systems, regulation, coverage, liability, damage evaluation, and/or settlement with exposures in excess of $1M Excellent at establishing close working relationships with other departments, including underwriting, operations, finance, IT, actuarial and legal Strong negotiating, analytical, written, and organizational skills Mediation and arbitration experience Strong computer skills (Microsoft Office Suite and in-house claims systems) Ability to prioritize and manage deadlines Ability to work both independently and collaboratively as part of a team Bachelor's degree required; JD preferred Excellent verbal and written communication skills Ability to analyze data and make sound judgments Ability to prioritize and manage deadlines Ability to work both independently and collaboratively as part of a team. Dedicated and hard-working Willingness to learn and apply concepts Able to work autonomously with strong organizational skills and the ability to plan ahead Keen attention to detail, highly analytical and excellent problem-solving capability Collaborative spirit Results-oriented, forward-thinking, and growth mindset.Senior 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.NewEmployee Benefits Head of Claims (HYBRID or REMOTE) Equitable Financial Life Insurance CompanyEmployee Benefits Head of Claims (HYBRID or REMOTE)NYRemote$360,000–$470,000 / yearp>''418883'',''true'',''418883'',''false'',''Submission for the position: Employee Benefits Head of Claims (HYBRID or REMOTE) - (Job Number: 260000C9)'',''false'',''418883'',''false'',''true'',''Employee Benefits Head of Claims (HYBRID or REMOTE)'',''260000C9'',''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'',''!*! Customer Experience Management: Knowledge of customer experience management; ability to implement strategies and techniques used to ensure that customers have a positive experience with the organization''s products and services at every touch point.Chief 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.Senior Casualty Claims Specialist – TPA Oversight Everest GroupSenior Casualty Claims Specialist – TPA OversightWarren, New Jerseydiv>Title: Senior Casualty Claims Specialist – TPA OversightCompany: Everest Insurance CompanyJob Category: ClaimsJob Description: About Everest:. Berg%40everestglobal.com%7C4684610f71aa4b91d22608dd662d95b5%7C0002cd247dd64542acd6e0c7e184c80c%7C0%7C0%7C638779068184154036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=YSL9XQs%2FJtn2nZcYoYaT1mmOhyI%2BUrByZFY%2FYaTj8Ns%3D&reserved=0" rel="nofollow noopener noreferrer" target="_blank">here to learn more about our culture.Claims Specialist II Everest GroupClaims Specialist IIWarren, New Jerseydiv>Title: Claims Specialist IICompany: Everest Insurance CompanyJob Category: ClaimsJob Description: About Everest: . Berg%40everestglobal.com%7C4684610f71aa4b91d22608dd662d95b5%7C0002cd247dd64542acd6e0c7e184c80c%7C0%7C0%7C638779068184154036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=YSL9XQs%2FJtn2nZcYoYaT1mmOhyI%2BUrByZFY%2FYaTj8Ns%3D&reserved=0" rel="nofollow noopener noreferrer" target="_blank">here to learn more about our culture.Senior 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.Private Client Claims Advocacy Leader Marsh & McLennan Companies IncPrivate Client Claims Advocacy LeaderNY$125,000–$233,000 / yearli>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. 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.Junior 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 / yearRefer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. Duties 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.Workers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY) NFP CorpWorkers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY)NY$40,000–$50,000 / yearWe help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location.12345678910Resume ResourcesFree Resume TemplatesFree Resume Builder
NewCasualty Claims Adjuster II EMC Insurance Group Inc.Casualty Claims Adjuster IINY$60,813–$84,038 / yearBy collaborating cross-functionally and acting as a trusted partner to agents, vendors, and internal teams, you will play a critical role in reducing risk, controlling costs, and strengthening relationships while continuously elevating the quality and integrity of the claims process. Step into a role where your expertise directly drives meaningful outcomes, leveraging your investigative instincts, sound judgment, and negotiation skills to bring clarity and resolution to complex claims.
Cyber Claims Advocate Marsh & McLennan Companies IncCyber Claims AdvocateNY$84,700–$180,300 / yearli>Liaises 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.
Voluntary Benefits Claims Manager New York Life Insurance CoVoluntary Benefits Claims ManagerNYRemote$45,000–$70,000 / yearPerform multi-policy checks where appropriate to determine if New York Life claimants with active disability and/or Life claims may be eligible for additional VB benefits as a result of their condition(s) in support of GBS service integration initiatives. We provide a full package of benefits for employees and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs.
NewClaims Examiner II Metroplus Health Plan IncClaims Examiner IINew York, NY$54,000–$64,474 / yearul>Bachelor's degree is required; a Master's degree is preferred, or an equivalent combination of education and relevant experience that demonstrates satisfactory equivalency. The ideal candidate will have experience processing healthcare claims in a high-volume Claims Department.
Claims 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.
Claims 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.
Epic 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.
Claims Supervisor Metroplus Health Plan IncClaims SupervisorNY$60,000–$70,000 / yearp>Required 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.
Senior Claims Reviewer Railway Health IncSenior Claims ReviewerNY$75,000–$100,000 / yearWhat we are looking for5+ years of experience in medical or stop-loss claims review, audit, or adjudicationMeticulous, analytical, and detail-oriented - you take pride in accuracy and root-cause thinkingExperienced in identifying inappropriate billing, duplicate charges, and coding errors (ICD-10, CPT, HCPCS, DRG)Comfortable communicating with TPAs, providers, and internal stakeholders to resolve discrepanciesIn-depth understanding of plan design, coordination of benefits, subrogation, and provider billing practicesFamiliarity with fraud, waste, and abuse (FWA) detectionStrong working knowledge of claims processing systems and supporting tools (Excel, SQL, Python)Bachelor's degree or equivalent experience in healthcare administration, insurance, or a related field. High Impact: You'll be working cross-functionally with operations and our data science team and your work will be key to building a health insurance company from scratch (where else can you do that??) Fast-Growing Startup: Join us at an inflection point - we're scaling quickly and thoughtfully.
Claims Intake Specilist Nesco Resource, LLCClaims Intake SpecilistNew York City, NY$33–$40 / hourp>Nesco 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.
Health Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNY$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.
Executive Claims Director Hamilton Insurance Group LtdExecutive Claims DirectorNew Jersey, NJExperience in handling severity and excess casualty claims or related litigation Experience working claims in the Excess and Surplus Market preferred Experience working with complex coverage issues required Multi-jurisdictional claims and litigation experience preferred Adjuster license and/or certifications preferred Highly advanced knowledge of claim processes, policies, procedures, claim systems, regulation, coverage, liability, damage evaluation, and/or settlement with exposures in excess of $1M Excellent at establishing close working relationships with other departments, including underwriting, operations, finance, IT, actuarial and legal Strong negotiating, analytical, written, and organizational skills Mediation and arbitration experience Strong computer skills (Microsoft Office Suite and in-house claims systems) Ability to prioritize and manage deadlines Ability to work both independently and collaboratively as part of a team Bachelor's degree required; JD preferred Excellent verbal and written communication skills Ability to analyze data and make sound judgments Ability to prioritize and manage deadlines Ability to work both independently and collaboratively as part of a team. Dedicated and hard-working Willingness to learn and apply concepts Able to work autonomously with strong organizational skills and the ability to plan ahead Keen attention to detail, highly analytical and excellent problem-solving capability Collaborative spirit Results-oriented, forward-thinking, and growth mindset.
Senior 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.
NewEmployee Benefits Head of Claims (HYBRID or REMOTE) Equitable Financial Life Insurance CompanyEmployee Benefits Head of Claims (HYBRID or REMOTE)NYRemote$360,000–$470,000 / yearp>''418883'',''true'',''418883'',''false'',''Submission for the position: Employee Benefits Head of Claims (HYBRID or REMOTE) - (Job Number: 260000C9)'',''false'',''418883'',''false'',''true'',''Employee Benefits Head of Claims (HYBRID or REMOTE)'',''260000C9'',''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'',''!*! Customer Experience Management: Knowledge of customer experience management; ability to implement strategies and techniques used to ensure that customers have a positive experience with the organization''s products and services at every touch point.
Chief 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.
Senior Casualty Claims Specialist – TPA Oversight Everest GroupSenior Casualty Claims Specialist – TPA OversightWarren, New Jerseydiv>Title: Senior Casualty Claims Specialist – TPA OversightCompany: Everest Insurance CompanyJob Category: ClaimsJob Description: About Everest:. Berg%40everestglobal.com%7C4684610f71aa4b91d22608dd662d95b5%7C0002cd247dd64542acd6e0c7e184c80c%7C0%7C0%7C638779068184154036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=YSL9XQs%2FJtn2nZcYoYaT1mmOhyI%2BUrByZFY%2FYaTj8Ns%3D&reserved=0" rel="nofollow noopener noreferrer" target="_blank">here to learn more about our culture.
Claims Specialist II Everest GroupClaims Specialist IIWarren, New Jerseydiv>Title: Claims Specialist IICompany: Everest Insurance CompanyJob Category: ClaimsJob Description: About Everest: . Berg%40everestglobal.com%7C4684610f71aa4b91d22608dd662d95b5%7C0002cd247dd64542acd6e0c7e184c80c%7C0%7C0%7C638779068184154036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=YSL9XQs%2FJtn2nZcYoYaT1mmOhyI%2BUrByZFY%2FYaTj8Ns%3D&reserved=0" rel="nofollow noopener noreferrer" target="_blank">here to learn more about our culture.
Senior 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.
Private Client Claims Advocacy Leader Marsh & McLennan Companies IncPrivate Client Claims Advocacy LeaderNY$125,000–$233,000 / yearli>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. 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.
Junior 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 / yearRefer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. Duties 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.Workers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY) NFP CorpWorkers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY)NY$40,000–$50,000 / yearWe help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location.12345678910Resume ResourcesFree Resume TemplatesFree Resume Builder
Workers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY) NFP CorpWorkers'''' Compensation Claims Assistant (Hybrid NYC or Albany, NY)NY$40,000–$50,000 / yearWe help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location.