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.
To 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.
CONSIDERED EXPERIENCE INCLUDES: Attorney Lawyer Insurance Company Litigation Policy Development Transaction #DiedreMoire #InsuranceJobs #AttorneyJobs #LitigationJobs #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting. 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, NJ27 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.
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.
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.
p>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. Learn more about working at Risk Strategies, part of the Brown & Brown team, by visiting https://us.bbrown.com/careers/.
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pre>Aon is looking for a Claims Specialist I As part of an industry-leading team, you will help empower results for our clients by delivering innovative and effective solutions supporting Aon Affinity, in our Plainview, NY office. Plus, our agile, inclusive environment allows you to manage your wellbeing and work/life balance, ensuring you can be your best self at Aon.
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.
li>Impactful Work: Contribute to a non-profit organization dedicated to improving healthcare processes and ensuring accurate claims adjudication that supports providers, patients, and healthcare plans. Review and provide case documentation to assigned billers/coders, nurses, physicians and clinicians internal teams, and key stakeholders to facilitate clinical and coding reviews.
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>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 in NYC, Dallas and Charlotte.
li>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.
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>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.
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. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
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.
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>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.
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.
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.
Berkley Heights, NJ5 days ago
Refer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. Duties and Responsibilities:
- Assisting in claims in accordance with Claim Handling Best Practices in all phases of the claim, including through initial contact, investigation of the claim, evaluation of the claim for coverage and reserving for exposure, and in the resolution and documentation of claims.
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.
li>Impactful Work: Contribute to a non-profit organization dedicated to improving healthcare processes and ensuring accurate claims adjudication that supports providers, patients, and healthcare plans. Review and provide case documentation to assigned billers/coders, nurses, physicians and clinicians internal teams, and key stakeholders to facilitate clinical and coding reviews.
Livingston, New JerseyToday
The Senior Claims Specialist will serve as a strategic claims advocate, managing complex claims from first notice through final resolution while driving optimal outcomes for internal stakeholders and clients. This role requires strong technical claims knowledge, sound coverage interpretation skills, and the ability to manage significant volume and competing priorities with accuracy and professionalism.
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.
p>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>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.
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.
New York City, New York27 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.
New York City, New York20 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.
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
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
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.
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").
Woodbridge, NJ30+ days ago
High school diploma or general education degree (GED) and related training (i.e. medical billing, medical terminology, data entry); or six months related experience; or equivalent combination of education and experience. The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service.
East Orange, NJ30+ days ago
p>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.
Woodbridge, NJ30+ days ago
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.