NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistMA$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.
NewOutside Property Associate Claim Representative The Travelers CompaniesOutside Property Associate Claim RepresentativeBraintree, MA$52,600–$86,800 / yearThis position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). As an Associate Claim Rep, Outside Property, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.
Outside Property Associate Claim Rep The Travelers Companies IncOutside Property Associate Claim RepWest Bridgewater, MA$52,600–$86,800 / yearThis position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). As an Associate Claim Rep, Outside Property, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.
Senior Claims Consultant/Director (00553) PMA Consultants CareersSenior Claims Consultant/Director (00553)Braintree, MADirects and reviews both 1) the development of a claim on behalf of a claimant and 2) reviews and analyzes claims submitted by a claimant, on highly complex claims involving delay, disruption, acceleration, loss of productivity, cumulative impact, differing site conditions, and termination issues. The Senior Construction Claims Analyst serves as a senior advisor to client stakeholders, legal counsel, and project leadership teams on matters involving delay, disruption, acceleration, change order entitlement, productivity impacts, cost recovery, and contract risk.
Casualty Claims Examiner I J.B. HuntCasualty Claims Examiner ILowell, MAFrom competitive salary and benefits packages, to defined career paths and growth opportunities, we take care of our people and take great pride in our efforts to build and sustain an inclusive workplace for all employees. Job Summary: Job Description: Qualifications: Compensation: Factors which may affect starting pay within this range may include skills, education, experience, geography, and other qualifications of the successful candidate.
Casualty Claims Intake Representative I J.B. HuntCasualty Claims Intake Representative ILowell, MAFrom competitive salary and benefits packages, to defined career paths and growth opportunities, we take care of our people and take great pride in our efforts to build and sustain an inclusive workplace for all employees. Job Summary: Job Description: Qualifications: Compensation: Factors which may affect starting pay within this range may include skills, education, experience, geography, and other qualifications of the successful candidate.
Complex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial Corp.Complex Claims Consultant/Specialist - Lawyers Professional LiabilityBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Complex Claims Consultant - Hospitals , Allied Facilities and Physicians CNA Financial CorpComplex Claims Consultant - Hospitals , Allied Facilities and PhysiciansBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex healthcare claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
NewComplex Claims Consultant - Healthcare Medical Malpractice CNA Financial Corp.Complex Claims Consultant - Healthcare Medical MalpracticeBoston, MA$72,000–$141,000 / yearResolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority. Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
NewWorkers Compensation Claims Specialist, East CNA Financial Corp.Workers Compensation Claims Specialist, EastBoston, MA$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.
NewDSNP Claims Resolution Coordinator Mass General BrighamDSNP Claims Resolution CoordinatorSomerville, MassachusettsRemote$19.81–$28.30 / hourThe DSNP Claims Resolution Coordinator is responsible for reviewing, researching, and resolving Dual Eligible Special Needs Plan (DSNP) claim inquiries, provider correspondence, and escalations received through Customer Service and internal business partners. This role determines whether claim adjustments are needed, applies Medicare and Medicaid benefit and payment guidelines, and ensures claims are processed accurately, timely, and in accordance with Mass General Brigham Health Plan policies, contractual requirements, and regulatory expectations.
Complex Claims Consulting Director - Healthcare Severity & Excess Team CNA Financial Corp.Complex Claims Consulting Director - Healthcare Severity & Excess TeamBoston, MA$97,000–$189,000 / yearCNA is a market leader in insuring Healthcare providers and entities including Allied Healthcare Facilities, Aging Services and Allied Healthcare Providers, including nurses, nurse practitioners, physical therapists, counselors, pharmacists, massage therapists, and more than 100 other categories of medical service providers. This role is responsible for analyzing complex coverage matters, driving claim resolution, managing complex litigation including risk transfer opportunities, advising leadership on legal and claim risks, and partnering with Underwriting and other business units on emerging trends and portfolio management.
Remote Claims Representative 630810 Metro Public AdjustmentRemote Claims Representative 630810Woonsocket, RIRemoteAccepting applications form Rhode Island, Connecticut, New Hampshire, Vermont, Maine, New York and New Jersey in the United States only. If you think you would be a great fit for our team, click Apply to seize this opportunity and shape your own future You will receive a link to schedule an informative interview session.
Sr. Examiner, Homeowner Claims Multi-State - Remote CSAA Insurance GroupSr. Examiner, Homeowner Claims Multi-State - RemoteMARemote$37.26–$41.40 / hourAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 21 more}. Serves as the owning adjuster for all assigned claims, including low- to higher-complexity losses that may require oversight of service providers conducting physical or virtual inspections.
Claims Supervisor 1 Concord General Mutual Insurance CompanyClaims Supervisor 1Westborough, MassachusettsSupervisory responsibilities include but not limited to: training and developing associates and conducting performance appraisals; planning, assigning, and directing work to meet Company objectives; ensure that associates consistently meet Company service expectations; addressing complaints and resolving problems; e. For those assigned a fleet vehicle: drive an automobile, possess a valid driver’s license, and maintain a driving record consistent with the Company’s underwriting guidelines for coverage.
NewPharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWaltham, MassachusettsSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
NewClaims Research & Resolution Representative Humana IncClaims Research & Resolution RepresentativeMARemote$40,000–$52,300 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Sr. Director, Claims Pricing Zelis Healthcare, Inc.Sr. Director, Claims PricingBoston, MA$169,000–$213,750 / yearThis role works closely with Claims Pricing & Revenue leadership to translate business priorities into actionable plans, strengthen operating performance, and identify opportunities to modernize claims pricing, repricing, negotiation, and related revenue operations. The Senior Director partners across Operations, Product, Technology, Analytics & Insights, Finance, Networks, Client Services and other key stakeholders to improve how work is performed and measured.
Claims Consultant -Life Sciences Or Cyber/Technology E&O (Hybrid) Intact InsuranceClaims Consultant -Life Sciences Or Cyber/Technology E&O (Hybrid)Canton, MA$143,000–$167,000 / yearSpecial consideration will be given to candidates who have personally litigated life sciences matters as attorneys and possess firsthand experience developing litigation strategy, managing scientific and expert evidence, conducting depositions, participating in trial preparation, and evaluating product liability and professional liability exposures from both the litigation and insurance claims perspectives. The ideal candidate will possess substantial Technology Errors & Omissions claims experience and a deep understanding of E&O coverage, including the ability to analyze complex professional liability exposures, contractual liability issues, performance disputes, and technology-related loss scenarios.
Claims Consultant -Life Sciences or Cyber/Technology E&O (Hybrid) Onebeacon Professional Insurance IncClaims Consultant -Life Sciences or Cyber/Technology E&O (Hybrid)Canton, MA$143,000–$167,000 / yearSpecial consideration will be given to candidates who have personally litigated life sciences matters as attorneys and possess firsthand experience developing litigation strategy, managing scientific and expert evidence, conducting depositions, participating in trial preparation, and evaluating product liability and professional liability exposures from both the litigation and insurance claims perspectives. The ideal candidate will possess substantial Technology Errors & Omissions claims experience and a deep understanding of E&O coverage, including the ability to analyze complex professional liability exposures, contractual liability issues, performance disputes, and technology-related loss scenarios.