Medical Director Wisconsin Physicians Service Insurance CorpMedical DirectorNewark, NJThe Contractor Medical Director (CMD) is responsible for researching and reviewing clinical evidence in support of developing Local Coverage Determinations (LCDs), conducting medical review (MR) activities, providing clinical program outreach activities, taking party or participant status in Administrative Law Judge (ALJ) appeals hearings, and performing appeals. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams.
Senior Claims Manager, Cyber HCC Life Insurance CompanySenior Claims Manager, CyberNew York, NY$146,900–$220,300 / yearThe 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. Relying on advanced knowledge and strong leadership skills, this role is accountable for the following responsibilities: Supervise and direct a team of claims professionals handling primarily Cyber, Media, and Technology Errors & Omissions claims and manage team workflow.
NewDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)New York, NY$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Financial Institution Associate Claim Counsel The Travelers Companies IncFinancial Institution Associate Claim CounselManhattan, NY$89,800–$148,300 / yearFollow operational policies to analyze, investigate, and resolve Financial Institution liability claims involving bank, asset management and insurance company accounts of varying levels of severity with active supervision from claims management. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies.
Director, Finance Arch Capital GroupDirector, FinanceJersey City, New JerseyThis includes monitoring dashboards for missing or incorrect/incomplete data, with the ability to research the issues and work with various internal and external business partners to keep track of open items, and ensure any necessary fixes are implemented. Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs.
AVP, Central Operations Services Arch Capital Group LtdAVP, Central Operations ServicesNJ$111,300–$172,700 / yearTotal individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential.
Construction Attorney Orion PlacementConstruction AttorneyNew York, New York$100,000–$150,000 / yearExperience: 3. Good fit job titles/keywords for candidates: Construction Attorney, Construction Litigation Attorney, Construction Law Associate, Construction Counsel, Mechanic’s Lien Attorney, Bond Claims Attorney, Construction Contracts Attorney, Delay Claims, Payment Bond, Performance Bond, Construction Defect, Procurement Disputes. Role can sit in New York City or White Plains and includes construction contracts, mechanic’s liens, bond claims, delay claims, defect claims, procurement disputes, and broader construction litigation/risk management.
NewManager, Software Engineering (Guidewire Application Development) - Remote or Hybrid (Jersey City or Raleigh) Arch Capital Group LtdManager, Software Engineering (Guidewire Application Development) - Remote or Hybrid (Jersey City or Raleigh)Jersey City, NJRemote$110,100–$170,600 / yearExtensive experience in Guidewire Claims Center including GW contact Manager, the integration gateway apps and integrations related to Eg ISO, MSP etc Extensive knowledge in guidewire cloud set up, guidewire tools (test automation tools), monitoring etc. Created to transition day-to-day ADM responsibilities from the Claims Domain Owner, this position will work closely with Product Owners, business stakeholders, and engineering teams to translate business requirements into scalable, high-quality technology solutions.
Head of Risk & Insurance ViaHead of Risk & InsuranceNew York, NY$200,000–$300,000 / yearPartner with senior leadership on risk strategy, including coverage decisions, alternative risk transfer (captives, self-insured retentions), and how risk and insurance figure into Via's broader operational and financial planning. Stand up the analytics that tell us whether the program is working: monitor loss ratios, claim frequency and severity, cost per mile, and retention thresholds and use them to inform every renewal.
Senior Associate Actuary Rider SolutionSenior Associate ActuaryTrenton, New Jersey$131,000–$160,000 / yearConduct pricing studies to assess the profitability of Auto and Homeowners insurance products and present findings to the Executive Leadership Team (ELT). The department encompasses teams such as Personal Lines Pricing, Commercial Lines Pricing, Reserving, and Predictive Analytics.
Manager Data Administration Rutgers The State University of New JerseyManager Data AdministrationNew Brunswick, NJAligned with Rutgers University-New Brunswick and collaborating university wide, RBHS includes eight schools, a behavioral health network, and five centers and institutes that focus on cancer treatment and research, neuroscience, advanced biotechnology and medicine, environmental and occupational health, and health care policy and aging research. Under Policy 100.3.1 Immunization Policy for Covered Individuals, if employment will commence during Flu Season, Rutgers University may require certain prospective employees to provide proof that they are vaccinated against Seasonal Influenza for the current Flu Season, unless the University has granted the individual a medical or religious exemption.
NewDental Billing Specialist scotchplain fanwood sdentalcareDental Billing Specialistfanwood, NJFull timeThe ideal candidate will be responsible for handling billing and insurance claims, processing patient payments, verifying insurance benefits, and supporting front office operations. This role is essential to ensuring accurate and timely financial transactions and maintaining excellent patient communication regarding billing matters.
Senior Claims Examiner, Professional Lines Coaction Specialty Insurance Group IncSenior Claims Examiner, Professional LinesMorristown, NJLeveraging deep technical expertise and a strategic mindset, you will oversee the full claims lifecycle-ensuring high-quality investigations, timely resolution, and alignment with corporate objectives, regulatory requirements, and Coaction's claim handling guidelines. Salary range specific to for this role: $103,000-$168,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance.
Senior Claims Examiner, Professional Lines Coaction Specialty Insurance GroupSenior Claims Examiner, Professional LinesMorristown, NJLeveraging deep technical expertise and a strategic mindset, you will oversee the full claims lifecycle-ensuring high-quality investigations, timely resolution, and alignment with corporate objectives, regulatory requirements, and Coaction's claim handling guidelines. Salary range specific to for this role: $103,000-$168,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance.
OON Mandate Negotiation Analyst-1 Blue Cross and Blue Shield AssociationOON Mandate Negotiation Analyst-1Newark, NJ$58,029–$77,074 / yearPrepares written responses including negotiation outcomes by completing a written justification on how Horizon BCBSNJ adjudicated the initial and adjusted claim, but not limited to, benefits, contracts, payment and pricing methodology, proof of plan and providing explanation of benefits within regulated timeframes. This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
NewStaff Software Engineer, Caching Capital Rx LLCStaff Software Engineer, CachingNew York, NY$200,800–$251,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and. Deep understanding of cache consistency and the failure modes that emerge at scale, such as thundering herd, hot key saturation, cache leasing, and dual-write consistency problems, and the judgment to choose the right invalidation strategy for a given workload.
Risk Management Liability Analyst Windstream Communications, LLCRisk Management Liability AnalystNY$50,000–$71,500 / yearPhysical Tasks- Standing Occasionally: 0-33% | Walking Occasionally: 0-33% |Sitting and Stationary: Continuously: 67-100% | Bending: Occasionally: 0-33% | Crouching: Occasionally: 0-33% | Carrying: Occasionally: 0-33% | Reaching: Occasionally: 0-33% |Lifting -Lowering >1-15 lbs: Occasionally: 0-33% | Repetitive Hand Action: Medium Dexterity: Continuously: 67-100% | Fine Manipulating: Frequently: 34-66%. With a steadfast commitment to customer service, operational excellence, and superior network capabilities, Uniti builds, operates and delivers critical fiber-based communications services to connect and empower people and businesses.
Customer Service Representative Chubb LtdCustomer Service RepresentativeNJThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Premier Coordinator Role: Work with assigned Premier Underwriter(s) to acquire and retain High Net worth Client''s policies and Family Office clients.
Senior Actuary, Outcomes Maven Clinic coSenior Actuary, OutcomesNew York, NY$149,000–$170,000 / yearAs a Senior Actuary, Outcomes at Maven, you will: Own claims and savings projections and retrospective analyses across Maven''s employer benefit programs-including performance guarantee assessments, value-based care arrangement modeling, and spend and enrollment projections across Maven''s full program portfolio. Founded 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.
Auto TPA Manager Coaction Specialty Insurance GroupAuto TPA ManagerMorristown, New JerseyRemoteWork with AVP of TPA Management and Legal to negotiate new contracts, and amendments for renewals and service level agreements (SLAs) with TPAs to establish clear expectations and performance metrics. Effective claim oversight requires strong technical expertise, project management, communication, and problem-solving skills, as well as a deep understanding of the specific services being outsourced.