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.
JobotNewWorkers 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.
GEICONewPIP Examiner GEICOPIP ExaminerHempstead, NY$29–$45.28We are looking for Personal Injury Protection (PIP) Claims Examiners in our Melville, NY office to deliver our promise to be there and assist our customers throughout the often-complicated medical aspects of auto insurance claims. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate’s work experience, education and training, the work location as well as market and business considerations.
Diedre Moire Corp.Insurance Claims Environmental Diedre Moire Corp.Insurance Claims EnvironmentalUnion City, NJ$110,000–$160,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs. 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.
Diedre Moire Corp.NewIns 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.
USAANewProperty Adjuster Specialist - Field USAAProperty Adjuster Specialist - FieldNew York, NY$85,050–$130,410 / yearProactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Metro Public Adjustment459763 Public Adjuster Metro Public Adjustment459763 Public AdjusterElberon, NJFull timeConduct a virtual walk-through inspection of the property, take some pictures, and fill out about 5 minutes worth of paper work. We are seeking motivated, self-starters in your area, who want to succeed.
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.Insurance Underwriter Diedre Moire Corp.Insurance UnderwriterWhite Plains, NY$100,000–$140,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Insurance Underwriter Specialty Program Excess Surplus Commercial Lines Program Underwriter #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.
Markel Group IncExecutive Claims Examiner, Cyber and Technology E&O Claims Markel Group IncExecutive Claims Examiner, Cyber and Technology E&O ClaimsRed Bank, NJThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
AllSearch Professional StaffingThird Party Liability Claims Examiner - Insurance Carrier - Base Salary to 100k/year - Great Neck, NY AllSearch Professional StaffingThird Party Liability Claims Examiner - Insurance Carrier - Base Salary to 100k/year - Great Neck, NYGreat Neck, NY$60,000–$100,000 / yearOur client, a large and growing insurance carrier, is seeking a Third Party Liability Claims Examiner to manage complex bodily injury, property damage, and litigated liability claims related to commercial trucking and business insurance policies. This role is responsible for investigating, evaluating, negotiating, and resolving third-party liability claims while coordinating with attorneys, TPAs, claimants, and internal teams.
TEEMA GroupCommercial Auto & General Liability Claims Examiner II TEEMA GroupCommercial Auto & General Liability Claims Examiner IINew York, NYRemote$85,000–$95,000Comprehensive Claims Management: Independently investigate and evaluate Commercial Auto, PIP, and General Liability claims to ensure high-quality outcomes. As a Claims Examiner II, you will manage and resolve complex Commercial Auto, No-Fault/PIP, and General Liability claims from initial intake through final disposition.
BerkleySr. Claims Examiner BerkleySr. Claims ExaminerJersey City, New Jersey$90,000–$140,000 / yearWe provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Responsibilities: The Senior Claims Examiner will be responsible for reviewing, processing, investigating, evaluating, negotiating and the settling of assigned property damage or bodily injury claims with the authority level generally up to $100,000.00.
Berkshire Hathaway GUARD Insurance CompaniesCommercial Liability Claims Adjuster - Litigated CGL Claims Berkshire Hathaway GUARD Insurance CompaniesCommercial Liability Claims Adjuster - Litigated CGL ClaimsParsippany, NJ$70,000–$115,000 / yearBerkshire Hathaway GUARD Insurance Companies is seeking a Complex Liability Adjuster to handle Commercial General Liability (CGL) and Business Owners Policy (BOP) claims, including litigated files. Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway.
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.
Raphael and AssociatesNew York Labor Law Claims Examiner Raphael and AssociatesNew York Labor Law Claims ExaminerRutherford, NJFull timeYou will have the ability to make a meaningful impact by leveraging your claim handling skills, industry expertise, customer service skills, and ability to execute with a high degree of professionalism. Most importantly, you will have the opportunity to work directly alongside an extraordinary and dedicated team to grow a critical function within a dynamic, growing company.
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.
BerkleyAVP, Claims Manager BerkleyAVP, Claims ManagerJersey City, New Jersey$180,000–$220,000 / yearWe provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $180,000-$220,000 • Eligible to participate in annual discretionary bonus.
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.
Amalgamated LifeNewDirector, 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.
Amalgamated LifeNewExecutive 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.
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.
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.
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.
Coaction Specialty Insurance Group IncClaims Examiner - Binding Authority Coaction Specialty Insurance Group IncClaims Examiner - Binding Authoritymorristown, NJRemoteCoaction is looking for talented and driven candidates who combine strategic thinking, creativity, and pragmatic execution to drive business results. If your application is selected, you will receive an email directly from the Coaction Recruiting Team at coaction@myworkday.com asking you to contact a member of the Coaction Recruiting Team.
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.
Ampcus IncorporatedNewClaims Examiner Ampcus IncorporatedClaims ExaminerNewark, NJ$16.95–$19.95 / hourSince 1995, iTech Solutions Inc., has been providing IT Consulting and Direct Hire Services to the Insurance, Financial, Communications, Manufacturing and Government sectors with local offices in Connecticut, Minnesota, Colorado, Massachusetts, Tennessee, North Carolina, and New Jersey / Pennsylvania area. We can honestly say our staff understands the technologies, the complexities of finding and selecting the appropriate personnel and the pressures of running successful IT projects.
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.
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.
MetLife IncLong Term Disability Claims Specialist II MetLife IncLong Term Disability Claims Specialist IINY$41,600–$62,500 / yearRegion: United States Working Schedule: Full-Time Work Arrangement: Virtual Relocation Assistance Available: No Posted Date: 24-Mar-2026 Job ID: 16386 Description and RequirementsRole Summary At MetLife we seek to make a meaningful impact in the lives of our customers and our communities. 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).
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.
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.
Career DevelopersNewClaims 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.
Human HireClaims Analyst Human HireClaims AnalystWhite Plains, NYResearch and perform claim investigations, update claims system with relevant notes, and handle various claim-related tasks. HumanHire is working with one of the largest insurance companies in New York, to help find a Claims Analyst for their White Plains office.
General Placement ServiceClaims Executive - Professional Liability General Placement ServiceClaims Executive - Professional LiabilityStamford, CTGeneral Placement Serviceis recruiting on behalf of for a top rated, Fortune 500 specialty insurance company with offices nationwide. In this role you will be responsible for handling litigated and non-litigated Professional Liability claims.
Hackensack Meridian HealthSupervisor, Specialty Claims & Accounts Receivable Hackensack Meridian HealthSupervisor, Specialty Claims & Accounts ReceivableTinton Falls, New JerseyAdditionally, this role supervises third-party follow-up activities across all payers including but not limited to HMO, Blue Cross, Commercial, Government, and Managed Care payers, Specialty and Client billing ensuring accounts are resolved promptly and effectively. Responsibilities: A day in the life of a Supervisor of Specialty Claims & Accounts Receivable at Hackensack Meridian Health includes: Monitor daily pre-billing, billing and follow up operations across HMH network, providing leadership and guidance to analysts and team members.
Oscar HealthDirector, Claims Operations, Process Improvement Oscar HealthDirector, Claims Operations, Process ImprovementNew York City, NY$180,504–$236,911.50 / yearLead team to surface data, process, and technology issues through proactive identification, measurement, and monitoring of operations; partner cross functionally to develop end-to-end strategy that leverages these insights to scale. Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week.
The Dignify Solutions, LLCNewQA Test Engineer with Medicaid and Claims - Remote The Dignify Solutions, LLCQA Test Engineer with Medicaid and Claims - RemoteJersey City, NJRemoteShould be able to run queries and perform basic system analysis, RCA etc., Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestone, track and close feedback from such demos. Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare.
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.
Chubb LtdSenior Claim Examiner-Multinational Chubb LtdSenior Claim Examiner-MultinationalJersey City, NJ$79,300–$134,700 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Chubb seeks a Senior Claim Examiner on the Multinational Casualty claims team that provides technical, specialized claim handling on behalf of Chubbs Multinational customers in the U.S. and abroad.
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.
Berkshire Hathaway GUARD Insurance CompaniesTrucking Claims Specialist Berkshire Hathaway GUARD Insurance CompaniesTrucking Claims SpecialistParsippany, NJ$105,000–$160,000 / yearOur companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! High-Cost Markets (e.g., New York City, Northern New Jersey, parts of California, Chicago) Estimated Base Salary Range: $105,000 - $160,000.
Career DevelopersJunior 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 / yearHandle 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 program Career Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence.
Utica Mutual Insurance CompanyComplex Liability Claims Specialist - Commercial General Liability Utica Mutual Insurance CompanyComplex Liability Claims Specialist - Commercial General LiabilityWoodbury, NY$103,300–$140,000 / yearPart timeThe ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel’s work product and working with defense counsel to efficiently and fairly resolve claims.
DB Insurance Co., Ltd.NewClaims Operations Specialist - HYBRID DB Insurance Co., Ltd.Claims Operations Specialist - HYBRIDGreat Neck, NYFull timeBacked by the financial strength of a global powerhouse (AM Best Rating: A+, S&P Rating: A+), we combine world-class resources with the agility of a close-knit team. Key Responsibilities: Manage and conduct pre- and post-payment adjudication audits on claim matters to ensure financial, processing, and operational accuracy.
W. R. Berkley CorpStop Loss Claims Analyst W. R. Berkley CorpStop Loss Claims AnalystNYRemote$70,000–$90,000 / yearElevate issues to next level of supervision, as appropriate Other duties as assigned Qualifications What you need to have: 3-5+ years stop loss claims experience Prior experience handling first dollar payer insurance (medical healthcare claims) Experience with medical billing practices, CPT codes, revenue codes, and/or universal billing Ability to use mathematics to adjudicate claims Detail oriented with a high degree of accuracy and ability to multitask Strong problem solving, decision-making, reporting and analytical skills Must possess good judgment and work effectively with internal business areas, peers and co-workers Demonstrated proficiency in Microsoft Office software What makes you stand out: Prior experience handling stop loss claims at the reinsurance level (medical healthcare claims) Ability to work independently, prioritize, organize and assign own work to meet deadlines Ability to accept changing priorities with a minimum of disruption Additional Company DetailsWe do not accept any unsolicited resumes from external recruiting firms. This position can either be fully remote (if not within commutable distance to the office) or based in one of our offices: Hamilton Square, NJ West Hartford, CT Marlborough, MA Kulpsville, PA We offer hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so.
Arch Capital Group LtdAVP, Casualty Claims - Excess Arch Capital Group LtdAVP, Casualty Claims - ExcessMorristown, NJ$170,000–$195,000 / yearDrives the development, implementation and continuous planning, organizing and leading of all claim programs, metrics, processes, results and initiatives across the Middle Market Excess claims unit and the E&S and Retail Energy claims unit. Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines.
Garuda Labs IncNewClaims Manager Contractor Garuda Labs IncClaims Manager ContractorNY$45–$50 / hourWhat You''ll Do: Report, oversee, monitor, and investigate insurance claims across all jurisdictions; Support Instawork with workers' compensation and occupational accident claims by running loss control surveys and training for teams involved in the claims reporting process as well as monthly data reporting requirements to carriers; Partner with insurance carriers to mitigate loss by evaluating and implementing tools, including but not limited to investigators and nurse case managers; Communicate frequently with internal stakeholders and third parties, including claims adjusters, brokers and other insurance personnel, injured Professionals, business Partners, doctors, and attorneys; Participate in monthly claim reviews to steer claims towards resolution; Maintain organized, accurate records of all claims and supporting documentation; Provide regular updates to senior management on claims activity; Analyze claims data to identify trends and areas for improvement; Develop, implement, and improve scalable processes and training to build a best-in-class claims function. Who You Are: 5+ years in insurance claims adjusting or management, including workers' compensation, occupational accident, and other injury and property damage claims; Impeccably organized; Detailed and process-oriented; Thorough knowledge of insurance lines and insurance laws across the United States; Composed handling high-priority escalations; Excellent verbal and written communication; Ability to analyze, classify, and rate risks, exposures, and loss expectancies; Marketplace risk experience preferred.