GEICOClaims Service Specialist GEICOClaims Service SpecialistSyosset, NY$23.91–$37.65Customer 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.
United Nations Federal Credit UnionGlobal Cards Solutions Specialist II - Operations United Nations Federal Credit UnionGlobal Cards Solutions Specialist II - OperationsNew York, NY$62,290 / yearFull timeUphold UNFCU’s mission, core values, and guiding principles by consistently demonstrating service excellence and delivering an exceptional experience to members and colleagues, regardless of role or seniority. Review chargeback and arbitration documentation for card fraud cases, determine appropriate action, and collaborate with the Accounting Department to reconcile fraud and dispute accounts.
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.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.
MetLife IncLong Term Disability Claims Specialist II MetLife IncLong Term Disability Claims Specialist IINY$41,600–$62,500 / yearRecognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. 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.
MetLife IncLong Term Disability Claims Specialist I MetLife IncLong Term Disability Claims Specialist IBloomfield, NJ$41,600–$60,500 / yearRecognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. 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").
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.
AXA SASenior Claims Specialist, Cyber AXA SASenior Claims Specialist, CyberNEW YORK, NY$117,000–$184,400 / yearManaging 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.
AXIS Capital Holdings LtdSenior Claims Specialist AXIS Capital Holdings LtdSenior Claims SpecialistNew York, NY$85,000–$130,000 / 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. Our focus is on hiring, developing, retaining, and rewarding individuals who excel in: Purposeful Action: Delivering top-tier work with a data-driven approach and operating at AXIS speed.
AXIS Capital Holdings LtdClaims Specialist - Management Liability AXIS Capital Holdings LtdClaims Specialist - Management Liabilitynew york, NY$73,000–$146,000 / 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. 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.
CorVel CorpNew England Claims Specialist CorVel CorpNew England Claims SpecialistNYRemote$52,999–$85,473 / yearThe 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.
Social Security AdministrationField Office - Claims Specialist (Bilingual) (Spanish/Creole) Social Security AdministrationField Office - Claims Specialist (Bilingual) (Spanish/Creole)East Orange, NJ$48,005–$94,563 / yearGS-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.
W. R. Berkley CorpClaims Specialist W. R. Berkley CorpClaims SpecialistJersey City, NJ$85,000–$160,000 / yearBachelor'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.
Liberty Mutual Holding Company IncSenior Technical Claims Specialist, Construction Defect Liberty Mutual Holding Company IncSenior Technical Claims Specialist, Construction DefectNY$97,000–$125,000 / yearResponsibilities: 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.
Equitable Financial Life Insurance CompanyDisability and Leave Management Claims Specialist (REMOTE) Equitable Financial Life Insurance CompanyDisability and Leave Management Claims Specialist (REMOTE)NYRemote$50,000–$60,000 / year418100'',''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.
Utica National Insurance GroupComplex Liability Claims Specialist - Commercial General Liability Utica National Insurance GroupComplex Liability Claims Specialist - Commercial General LiabilityWoodbury, NY$103,300–$140,000 / yearThe 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.
Coterie Applications IncLiability Claims Specialist Coterie Applications IncLiability Claims SpecialistNYRemote$75,000–$105,000 / yearExceptional communication, written and verbal, influencing, evaluation, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal and external peers and other professionals across organizational lines. Develop and implement strategy to resolve Commercial Property and Casualty General Liability, Property and Professional Liability claims of moderate level of severity and complexity, but may be required to handle volume.
Axis Capital HoldingsClaims Specialist - Primary Casualty Axis Capital HoldingsClaims Specialist - Primary CasualtyNew York, NY$75,000–$130,000 / yearDrafting coverage positions to be reviewed and approved by Claim Manager Working closely with Insureds, Claimants, attorneys and brokers ensuring a premier and best practices claim service is maintained, escalating issues as appropriate. Setting accurate and timely claim reserves and make referrals to Claim Manager where necessary Managing the lifecycle of a claim from notification to closure, ensuring timely and accurate resolution.
Utica National Insurance GroupCommercial Lines Claims Specialist - Commercial General Liability (Northeastern Venues) Utica National Insurance GroupCommercial Lines Claims Specialist - Commercial General Liability (Northeastern Venues)Woodbury, NY$77,000–$110,000 / yearWe 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.
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.
Argo Group International Holdings IncNewSenior Construction Defect Technical Claims Specialist Team Lead Argo Group International Holdings IncSenior Construction Defect Technical Claims Specialist Team LeadNew York City, NYRemote$156,000–$187,500 / yearBoston 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.
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.
BerkleySenior General Liability Claims Specialist BerkleySenior General Liability Claims SpecialistJersey City, New Jersey$110,000–$160,000 / yearResponsibilities: 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.
BerkleySr. Claims Specialist BerkleySr. Claims SpecialistJersey City, New Jersey$110,000–$160,000 / 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: $110,000-$160,000 • Eligible to participate in annual discretionary bonus.
BerkleyClaims Specialist BerkleyClaims SpecialistJersey City, New Jersey$100,000–$150,000 / 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: $100,000-$150,000 • Eligible to participate in annual discretionary bonus.
Axis Capital HoldingsSenior Claims Specialist, Excess Casualty Axis Capital HoldingsSenior Claims Specialist, Excess CasualtyNew 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.
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.
Maven ClinicNewSenior Associate, Claims and Benefits Specialist Maven ClinicSenior Associate, Claims and Benefits SpecialistNew York, NY$98,000–$107,000 / yearFounded in 2014 by CEO Kate Ryder, Maven has raised more than $425 million in funding from top healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. You will partner closely with Payment Operations, Payment Integrity and QA, Engineering, Revenue Cycle Management, Member benefits and external TPAs to ensure billing precision, financial integrity, and member trust.
Argo Group International Holdings IncNewSr Field Claims Specialist Argo Group International Holdings IncSr Field Claims SpecialistNY$68,100–$105,000 / yearFarm Family specializes in farm and ranch protection with a wide range of products including flexible farm packages, business owner policies, commercial package, workers compensation, commercial auto and select personal auto coverage. Farm Family is a leader in serving the Northeast and Mid-Atlantic markets and is pursuing growth across the U.S. The Farm Family entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.
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.
CNA Financial CorpCommercial Auto Claims Specialist CNA Financial CorpCommercial Auto Claims SpecialistMelville, NY$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
American International Group Inc (AIG)NewClaims Specialist III, Auto & General Liability American International Group Inc (AIG)Claims Specialist III, Auto & General LiabilityJersey City, NJ$84,000–$101,000 / yearMaintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution. Analyze and process general liability property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans.
Axis Capital HoldingsSenior Claims Specialist, Excess Casualty Claims - NA Axis Capital HoldingsSenior Claims Specialist, Excess Casualty Claims - NANew York, NY$140,000–$160,000 / yearSenior Claims Specialist, Excess Casualty - North America Claims Job Code 13573 About the Team AXIS is hiring a Senior Claims Specialist, Excess Casualty, to support its expanding presence in North America's Excess market. About You We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals.
Axis Capital HoldingsSenior Claims Specialist, Primary Claims Axis Capital HoldingsSenior Claims Specialist, Primary ClaimsNew York, NY$105,000–$160,000 / yearassociated with claim Reviewing contracts for risk transfer evaluations, coverage analysis and tender review Investigating potentially fraudulent claims and takes appropriate action Identifying opportunities for contribution, subrogation and contribution to the claim About You We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals. Have the ability to mentor and develop the professional skills of junior adjusters Have prior experience handling New York Labor Law, Product Liability and Complex litigation claims Have experience in drafting coverage correspondence, experience writing coverage letters and responding to/issuing tenders Be skilled in negotiating settlements with various stakeholders to achieve equitable solutions.
US Anesthesia PartnersNewAccounts Receivable Specialist: Denials & Claims Expert US Anesthesia PartnersAccounts Receivable Specialist: Denials & Claims ExpertNew York, NY$18.17–$29.04 / hourU.S. Anesthesia Partners is looking for an Accounts Receivable Specialist – RCM to manage collections from third-party payers. The role offers a pay range of $18.17 - $29.04 hourly and is eligible for bonuses based on performance.#J-18808-Ljbffr.
The Progressive CorpNewClaims Administrative Support Specialist The Progressive CorpClaims Administrative Support SpecialistRutherford, NJ$23.56–$25.17 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/. In addition to ensuring essential administrative functions run smoothly, you may also interact with customers and medical providers by phone or in person when applicable.
Genworth Financial IncNewClaims Clinical Specialist - Medical Review Team Genworth Financial IncClaims Clinical Specialist - Medical Review TeamNYAt least two years-experience working in a role that required an understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential. The final determination on base pay for this position will be based on multiple factors at the time of this job posting including but not limited to geographic location, experience, and qualifications to ensure pay equity within the organization.
US Tech SolutionsSpecialist # 26-12682 US Tech SolutionsSpecialist # 26-12682New York, NY$35–$36.71 / hourContractorFull timeTo determine whether advertising is truthful and accurate, Associates must be able to identify express and implied claims and assess the adequacy of a variety of forms of supporting documentation submitted by Advertisers to support such representations, including studies, market research and related complex industry-specific data. Working knowledge or familiarity with advertising or marketing laws; FTC, FCC, and FDA regulations; clinical analysis; product testing; market research and/or statistical analysis.
GEICO GENERAL INSURANCE COMPANYClaims Service Specialist GEICO GENERAL INSURANCE COMPANYClaims Service SpecialistMelville, NY$23.91–$37.65 / hourCustomer 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.
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.
Luster NationalNewSenior Claims and Change Specialist Luster NationalSenior Claims and Change SpecialistNewark, NJ$150,000–$190,000 / hourThis role functions as a senior individual contributor within established governance and approval structures, applying advanced claims analysis, claims management, contracts, and change management expertise on major design build contracts while independently leading claims strategy, analysis, and negotiation; change management and formal notice letters; contract interpretation and dispute response; owner and attorney interactions; and providing commercial risk insight for a $2B contract package. The position works closely with construction management, project controls, and contract administration teams to evaluate Notices of Change (NOCs), develop and document entitlement positions, support negotiations, and ensure adherence to defined change control processes and audit expectations in politically sensitive, federally scrutinized environments.
Amtrust Financial Services IncComplex Claim Specialist, New York Labor Law Amtrust Financial Services IncComplex Claim Specialist, New York Labor LawNew York, NY$126,000–$155,000 / yearThe successful candidate will evaluate coverage issues and risk transfer opportunities as well as ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, and proper negotiation strategy is employed. Ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, proper negotiation strategy is employed.
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.
Arch Capital Group LtdComplex Claims and Coverage Specialist Arch Capital Group LtdComplex Claims and Coverage SpecialistNew York, NY$145,700–$175,000 / yearThe successful candidate will have significant coverage experience as well as GL (Bodily Injury and Property Damage) and Auto Liability complex/large exposure claim handling experience, a passion for achieving excellent claim results and for delivering exceptional customer service. Assist CAM's and others with TPA management and oversight to include: TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation/vendor management, legal/regulatory developments, customer service and other topics that may arise.
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.
Dane StreetNewRemote LTD Claims QA Specialist Dane StreetRemote LTD Claims QA SpecialistNew York, NYRemote$22–$30 / hourWe offer competitive pay ranging from $22.00 to $30.00 per hour, remote work options, and a comprehensive benefits package including health insurance, retirement plans, and generous paid time off.#J-18808-Ljbffr. This role requires a strong background in claims, attention to detail, and excellent communication skills.
State FarmNewClaim Specialist - Property Field Inspection State FarmClaim Specialist - Property Field InspectionNewark, NJ$73,824.56–$112,500 / year07003 07008 07009 07011 07012 07013 07014 07016 07017 07018 07028 07033 07036 07040 07041 07042 07043 07044 07050 07052 07055 07065 07079 07083 07088 07102 07103 07104 07105 07106 07107 07108 07109 07110 07111 07112 07114 07201 07202 07203 07204 07205 07206 07208 07424 07503 07512 07513. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!
Amtrust Financial Services IncSenior Complex Claim Specialist, Professional Liability Amtrust Financial Services IncSenior Complex Claim Specialist, Professional LiabilityNY$114,000–$165,000 / yearThe successful candidate will evaluate coverage issues and risk transfer opportunities as well as ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, and proper negotiation strategy is employed. Ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, proper negotiation strategy is employed.
Alera Group IncNewPart-time Biller/Coder - Claims Analyst Alera Group IncPart-time Biller/Coder - Claims AnalystNYRemote$50–$65 / hourThe Part-time Biller/Coder - Claims & Alert/Trigger Criteria supports Vital Oversight's continuous monitoring of medical and pharmacy claims by reviewing claims for coding accuracy and reimbursement appropriateness and by developing and maintaining alert and trigger logic that identifies high-risk or outlier claims. This role works collaboratively with claims, clinical, and oversight stakeholders to surface actionable findings that support proactive cost and payment integrity oversight.
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.