div>Proactively 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.
White Plains, NY30 days ago
CONSIDERED 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.
Union City, NJ21 days ago
CONSIDERED 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.
New Hyde Park, NY28 days ago
The Out-of-Network Authorization Specialist is responsible for securing prior authorizations and verifying benefits for services rendered by providers who are not contracted with a patient’s insurance plan. This role requires strong communication skills, attention to detail, and a deep understanding of payer policies to ensure accurate billing and minimize claim denials.
This role ensures accurate and timely claims processing, identifies and resolves discrepancies, and serves as a key liaison between internal teams, providers, and payers. Maintain working knowledge of billing concepts including HCPCS/CPT modifiers, reimbursement methodologies, and service-specific billing requirements (e.g., hospital, ambulance, anesthesia).
Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. Coordinate cross‑functional and cross‑site collaboration with Unit Leaders, business consultants, training partners, systems teams, and peers to resolve discrepancies, support multidisciplinary claim discussions, align on best practices, and ensure consistent, accurate claim administration.
418100'',''true'',''418100'',''false'',''Submission for the position: Disability and Leave Management Claims Specialist (REMOTE) - (Job Number: 260000AF)'',''false'',''418100'',''false'',''true'',''Disability and Leave Management Claims Specialist (REMOTE)'',''260000AF'',''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'',''!*! Managing Multiple Priorities: Knowledge of effective self-management practices; ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation.
The Claims Specialist directs the management of claims including claims investigation, coverage analysis, monitoring of defense counsel activities, control of legal expenses, reserving, and providing technical expertise throughout the life of the claim file. For that reason, we partner with The Predictive Index (PI) - an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one's work style.
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte.
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Risk Strategies is the 9th largest privately held U.S. brokerage firm offering comprehensive risk management advice, insurance and reinsurance placement for property & casualty, employee benefits, private client services, as well as consulting services and financial & wealth solutions. The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role.
This 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.
p>Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. The Long-Term Disability Claims Specialist II is responsible for evaluating and managing long term disability claims, making timely and accurate claim decisions, and delivering a responsive and supportive customer experience that helps MetLife serve customers with care and confidence across the United States.
p>Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. Excellent interpersonal and communication skills in both verbal/written form and excellent customer service skills proven through internal/external customer interactions with demonstrated conceptual thinking, risk management, ability to handle complex situations effectively with organizational and time management skills.
Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success.
The Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the "VCCLEA"), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. Handles claims that involve the investigation of coverage, liability, damages and resolution of both non-litigated and litigated claim files for primary casualty lines, There will be some handling of small contractor artisan claims and project specific policies with emphasis on complex Construction Defect and Owners, Landlords & Tenant (OL&T), as well as wrap claims throughout the United States.
Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success.
p>We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including NYC, Dallas, and Charlotte.
p>The Disability Claims Specialist (DCS) is accountable for direct support of the Team Lead on the claim team ensuring optimal claims handling and timely, accurate decisions of the claim team. In addition, the role requires but is not limited to the following skills:
p>Senior Claims Specialist - EPL/Fiduciary Job Code 13574 About the Team AXIS is hiring a Senior Claims Specialist EPL and Fiduciary Claims for its North America Claim Team. 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.
Previous experience with the reserving and adjudication of the following: Workers' compensation lost time claims, Workers' compensation claim investigations (including subrogation and compensability decisions. The Lost Time Claims Specialist II will apply litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company.
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including NYC, Dallas, and Charlotte.
Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. Guided by our purpose - always with you building a more confident future - and our New Frontier strategy focused on stronger growth, attractive returns and all-weather performance, this is an exciting opportunity to partner closely with claimants and internal/external resources to assess ongoing disability, document the file appropriately, set expectations, and ensure bridging actions are completed timely and accurately.
Primary products include but are not limited to: Employer Stop Loss, Leisure Travel, Accident Medical, Pet, Line of Duty, Limited Medical Benefits, Accident Medical, Critical Illness, Vision, Dental and Short-term Disability. This position provides senior claims handling expertise for all product lines of the Accident and Health division, both claims adjudicated in-house and by Third-Party Administrators (TPAs).
p>Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
Coordinating and managing communication with internal colleagues and key external stakeholders (e.g., clients, brokers, reinsurers, vendors, etc.) ensuring we are providing the highest level of customer service Responsive claims management in direct coordination with a diverse team of specialists: computer forensics, data breach notification and call center services, credit and ID monitoring, public relations and expert legal counsel. Managing assigned complex Cyber and Technology claims across multiple jurisdictions, setting the case strategy for these claims in partnership with the Cyber Practice Leader and Claims Management, and taking all available steps to achieve the optimal outcome.
p>Managing assigned complex Cyber and Technology claims across multiple jurisdictions, setting the case strategy for these claims in partnership with the Cyber Practice Leader and Claims Management, and taking all available steps to achieve the optimal outcome. 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.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. https://www.greatamericaninsurancegroup.com/about-us/business-operations/division/alternative-markets.
The Workers' Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
p>This role reports to the Head of Wholesale Claims - Financial Lines and is responsible for investigating, analyzing, and evaluating EPL claims, ensuring proper coverage determinations and navigating claims to successful conclusions. This role is on the Wholesale Financial Lines Claims team, which handles excess and primary claims for Employment Practices Liability (EPL), Directors and Officers (D&O), and related lines.
The Workers' Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
The 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. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities.
Bloomfield, NJ30+ days ago
Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
New York City, New York14 days ago
p>Our CCPA Job Applicant Policy is found here: Sirius-America-CA-Job-Applicant-Privacy-Policy-Final.pdf. The Claims Specialist will interact frequently with brokers and clients, evaluate claim notices, and approve authorizations and financial transactions on behalf of SiriusPoint.
ul>Customer Interaction: Manage incoming calls, collect accident facts, investigate claim details, collect statements from involved parties, and assist in the process of getting our customers back on the road. 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.
East Orange, NJ29 days ago
GS-7: One (1) year of specialized experience at the GS-5 level (or equivalent) that demonstrates the ability to (1) assist individuals in establishing their entitlement to receive benefits (e.g., retirement, disability, public aid, insurance, taxes, etc.); (2) adjudicate, authorize or reconsider claims; (3) explain benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) entitlements or requirements to the general public; (4) evaluate benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) program operations to assess the integrity and quality; or (5) interpret benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) program requirements to formulate policies, procedures or guidelines. If you are using experience to qualify, you must have: GS-5: Three years of general experience equivalent to the next lower grade level in the federal service that demonstrates the ability to 1) review problems to identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; and 3) communicate effectively orally and in writing.
New York City, New York21 days ago
div>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.
The 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.
Jersey City, NJ30+ days ago
Bachelor's degree preferred At least 10+ years relevant industry GL claim handling experience Multi state experience required Litigation experience required Ability to work independently while assimilating various technical subjects. We 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.
Jersey City, NJ30+ days ago
We 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: $110,000-$160,000 • Eligible to participate in annual discretionary bonus.
Jersey City, NJ30+ days ago
p>The Senior General Liability Claims Specialist 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 $150,000.00. We 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: Determines coverage (including additional insured and contractual tenders in and out), prepares concise and thoughtful coverage positions letters, investigates the claims, determines liability, sets and adjusts reserves (Loss and Supplementary Payments/Allocated Loss Adjustment Expense - proactive and reactionary), evaluates the claim, negotiates a settlement, authorizes and pays the claim; may deny claims; may deny coverage and/or manage coverage litigation. The Senior Technical Claims Specialist determines coverage, investigates highly complex commercial casualty claims, determines liability, sets and adjusts reserves, evaluates the claim, manages the litigation, negotiates a settlement, authorizes and pays or denies the claim, in whole or in part.
New York City, NY19 days ago
Essential 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.
New York City, NY20 days ago
Essential 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.
Boston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Qualifications / Experience Required: A deep knowledge of construction defect claims adjudication, along with an exceptional focus on customer service, typically achieved through: A minimum of seven years' experience adjudicating construction defect claims with exposure of $100,000 or more.
Alternatively, we are also open to consider candidates working from home anywhere in the continental United States This individual will report to a manager who works in New York City and is focused on adjudicating first and third party commercial environmental claims (mostly complex storage tank claims) and contributing to providing superb results for our clients. Boston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C.