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.
GEICOPIP 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.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.
USAAProperty 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.
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.
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.
Markel Group IncClaims Examiner, Inland Marine - Transportation Claims Markel Group IncClaims Examiner, Inland Marine - Transportation ClaimsNew York, NY$62,400–$85,800 / yearThis 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. Provides timely service throughout the life cycle of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquiries according to company policy and procedures.
TEEMA GroupNewCommercial 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.
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.
Markel Group IncSr. Claims Examiner Markel Group IncSr. Claims ExaminerNew York, NY$78,000–$107,250 / yearThis 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. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all internal and external stakeholders.
Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | NY Jurisdiction | Dedicated Client Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | NY Jurisdiction | Dedicated ClientNYRemote$80,000–$90,000 / yearSedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
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.
Howden Group Holdings LtdSr. Casualy Claims Examiner Howden Group Holdings LtdSr. Casualy Claims ExaminerNYRemote$125,000–$145,000 / hourDraft well written and comprehensive captioned reports to request reserve and settlement authority on higher exposure cases that outline all critical aspects of the case in preparation for roundtable presentations to the carrier partners. Supporting the Construct Defect Claims team, you will independently manage moderate to high exposure claims involving alleged defects in residential and commercial construction.
Howden Group Holdings LtdNewSr. Casualty Claims Examiner Construction Howden Group Holdings LtdSr. Casualty Claims Examiner ConstructionNY$125,000–$145,000 / yearDraft well written and comprehensive captioned reports to request reserve and settlement authority on higher exposure cases that outline all critical aspects of the case in preparation for roundtable presentations to the carrier partners. Supporting the Construct Defect Claims team, you will independently manage moderate to high exposure claims involving alleged defects in residential and commercial construction.
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.
Markel Group IncNewExecutive Claims Examiner Markel Group IncExecutive Claims ExaminerNew York, NY$97,520–$134,090 / yearThis 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 internal business partners, including claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Sedgwick Claims Management Services, Inc.Workers'''' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | Remote Sedgwick Claims Management Services, Inc.Workers'''' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | RemoteNJRemote$70,000–$80,000 / yearTo analyze Medical Only & Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | NY Jurisdiction Experience Required | Dedicated Client Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | NY Jurisdiction Experience Required | Dedicated ClientTelecommuter, NY$70,000–$80,000 / yearPRIMARY PURPOSE OF THE ROLE: To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Sedgwick Claims Management Services, Inc.NewWorkers Compensation Claims Examiner | NY Jurisdictional Experience Required | Dedicated Client Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | NY Jurisdictional Experience Required | Dedicated ClientTelecommuter, NY$80,000–$90,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding Auditory/Visual: Hearing, vision and talking #claimsexaminer #claims #remote As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | NY Jurisdictional Experience Required | Dedicated Client Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
MVP Health CareNewAssociate, Claims Examiner MVP Health CareAssociate, Claims ExaminerNY$20–$26.60 / hourAn opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care.
Metropolitan Transportation AuthorityClaims Manager, No Fault Metropolitan Transportation AuthorityClaims Manager, No FaultNew York, NY$99,204–$110,227 / yearOpening: The Metropolitan Transportation Authority is North America's largest transportation network, serving a population of 15.3 million people across a 5,000-square-mile travel area surrounding New York City, Long Island, southeastern New York State, and Connecticut. Claims Manager, No Fault is responsible for directing and overseeing no-fault claims handling and settlement decisions, interpreting and applying no-fault statutes and case law to complex claims, and developing and maintaining guidelines, procedures, and quality controls that govern no-fault claims adjudication.
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.
Prudential Financial IncSenior Disability Claims Examiner, Concierge Team (Virtual) Prudential Financial IncSenior Disability Claims Examiner, Concierge Team (Virtual)Newark, NJ$61,700–$101,900 / yearThe role will require the ability to analyze information specific to earned income, contractual provisions, and benefits paid to ensure the accuracy of partial disability payments on disability claims as outlined within the policy. Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.
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.
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.
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.
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.
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.
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.
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.
AXIS Capital Holdings LtdClaims Manager - Excess Casualty Claims AXIS Capital Holdings LtdClaims Manager - Excess Casualty ClaimsShort Hills, NJ$160,000–$190,000 / yearClose collaboration with the Specialty Complex Claims team with regard to coverage disputes, including litigation and arbitration matters initiated by Axis issuing companies and when Axis issuing companies are parties to such litigation; Collaborating across disciplines and business units, including: the general counsel team overseeing errors and omissions issues arising from claims handling. Identifying, liability and coverage trends and issues with both individual and portfolio impact and formulating the processes and strategies for handling such claims as well as ensuring accurate and consistent claims management across impacted underwriting segments and lines of business.
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.
Arch Capital Group LtdSenior Auto Claims Examiner - UM/ UIM Arch Capital Group LtdSenior Auto Claims Examiner - UM/ UIMNew York, NY$123,400–$156,633 / yearInjury Adjuster- UIM/ UM, you will be responsible to adjust low to moderately complex UM/UIM claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims while adhering to Arch's handling guidelines.
HealthCare Partners, MSOClaims Audit Coordinator HealthCare Partners, MSOClaims Audit CoordinatorGarden City, NY$50,000–$60,000 / hourOur network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners.
Argo Group International Holdings IncNewSenior Technical Claims Specialist Argo Group International Holdings IncSenior Technical Claims SpecialistNew York City, NY$151,062–$181,254 / yearEssential Responsibilities: Working under limited oversight under broad management direction, adjudicate New York Labor Law claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results. Qualifications / Experience Required: A deep knowledge of adjudicating New York Labor Law claims, as well as exceptional customer service focus, typically achieved through a minimum of: Seven years' experience adjudicating commercial general liability claims with a focus on New York Labor Law.
Argo Group International Holdings IncNewSenior Technical New York Labor Law Claims Specialist Argo Group International Holdings IncSenior Technical New York Labor Law Claims SpecialistNew York City, NY$151,062–$181,254 / yearEssential Responsibilities: Working under limited oversight under broad management direction, adjudicate New York Labor Law claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results. Qualifications / Experience Required: A deep knowledge of adjudicating New York Labor Law claims, as well as exceptional customer service focus, typically achieved through a minimum of: Seven years' experience adjudicating commercial general liability claims with a focus on New York Labor Law.
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.
Maven ClinicNewSenior Product Manager, Claims & Payments, Payer Integrations & Clinic Experience Maven ClinicSenior Product Manager, Claims & Payments, Payer Integrations & Clinic ExperienceNew York City, NY$160,000–$185,000 / yearYou will sit at the intersection of provider operations, payments infrastructure, payer integrations, and partner relationships, from provider payment workflows and payment reconciliation to claims submission, 835 remittance processing, payer integrations that connect Maven's financial infrastructure to health plan partners, and clinic portal enhancements that make Maven turnkey for fertility networks and clinic partnerships. We are looking for a senior, hands-on product manager to own and evolve Maven's provider payments, claims-based billing, payer integrations, and clinic experience, the systems and workflows that power how clinic partners, providers, health plan partners, and Maven transact, exchange claims data, reconcile payments, and operate together at scale.
VNS HealthClaims 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.
ServiceMaster RestoreNewClaims 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.
Aon CorporationSenior Claims Advocate, Financial Services Group Aon CorporationSenior Claims Advocate, Financial Services GroupNew York, New York$91,800–$114,800 / yearAs part of an industry-leading team, you will help empower results for our clients by delivering innovative and effective solutions as part of our Financial Services Group Legal and Claims Practice Group. We are proud of the investment our firm has made in this valuable client resource and firmly believe Aon’s Legal and Claims Practice Group is a significant competitive advantage for our clients.
EmblemHealth IncSr. Claims Project Specialist EmblemHealth IncSr. Claims Project Specialistnew york, NY$68,040–$118,800 / yearQualificationsBachelor's DegreeProject Management (PMI) or Six Sigma/related certification preferred4 - 6+ years' experience with claims, claims support, vendor oversight, analytics and/or UAT management requiredHealth plan industry experience requiredProven track record of successfully managing medium to large (division/department) projects requiredExperience in staff and process management in positions with a history of increasing responsibility requiredAdditional years of experience and/or training/certifications may be considered in lieu of educational requirements requiredExperience utilizing metrics and analytics to define and verify outcomes and performance relative to SLAs requiredHealth plan functional, operational, analytic and/or UAT domain expertise requiredStrong communication skills (verbal, written, presentation, interpersonal) requiredProficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.) requiredAdditional InformationRequisition ID: 1000002775Hiring Range: $68,040-$118,800. Lead cross-functional teams (Payment Integrity, Provider Claims Resolution, Grievance and Appeals, Provider Network Management, Customer Service) to track/monitor the resolution of Claims Issue (medical, hospital and dental) for HMO/PPO claims (Facets).Monitor/Analyze claims issues to identify trends, inefficiencies, and potential risks.
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.
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.
Computer Task Group, IncEpic HB Admin / HB Claims Remit Computer Task Group, IncEpic HB Admin / HB Claims RemitNY$125,000–$135,000 / yearKey Responsibilities Provide day-to-day support for Epic HB Admin, Claims, and Remittance (Remit) workflows across revenue cycle operations Troubleshoot and resolve issues related to claims processing, billing edits, and remittance posting Configure and maintain Epic HB billing rules, charge router, claim edits, and remittance logic Analyze claim rejections/denials and partner with operations teams to implement root cause solutions Support EDI transactions, clearinghouse integrations, and payer-specific requirements Monitor system performance and conduct proactive audits to ensure billing accuracy and compliance Collaborate with revenue cycle stakeholders (billing, coding, finance) to support end-to-end workflows Participate in system upgrades, enhancements, testing cycles, and optimization initiatives Develop and maintain documentation, workflows, and training materials for operational teams Provide production support including issue triage, incident management, and resolution tracking Required Qualifications Epic HB Certification(s) - required (HB Admin strongly preferred; Claims/Remit experience required) 5+ years of Epic HB experience, including Admin, Claims, and Remittance functionality Strong experience supporting hospital revenue cycle operations, including billing, claims management, and payment posting Deep understanding of claims lifecycle, denials management, and remittance processing (835/ERA) Hands-on experience with Epic build, configuration, and support within HB modules Knowledge of EDI transactions, clearinghouses, and payer rules Proven ability to troubleshoot complex issues and work directly with operational stakeholders Strong communication skills with the ability to translate technical concepts to non-technical users Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required. This individual will play a key role in maintaining and optimizing Epic HB (Hospital Billing) workflows, with a strong focus on claims processing, remittance, and operational support.
Deloitte Touche Tohmatsu LtdInsurance Claims Business Analyst Deloitte Touche Tohmatsu LtdInsurance Claims Business AnalystMorristown, NJ$128,000–$252,500 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Mount Sinai Health SystemNewHealth Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNew York, NY$64,526.72–$81,675 / yearMount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.