Complex Claims Consultant - Hospitals , Allied Facilities And Physicians CNA Financial Corp.Complex 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.
Complex Claims Specialist - Professional Liability (Real Estate) CNA Financial Corp.Complex Claims Specialist - Professional Liability (Real Estate)Boston, 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.
Claims Account Manager, Wholesale AXA SAClaims Account Manager, WholesaleBOSTON, MA$139,300–$219,300 / yearClaims Account Manager - Wholesale Location - Exton, Hartford, NYC, Chicago As a Claims Account Manager - Wholesale, you will be responsible for claim account management functions for customers in our growing Wholesale (Programs, Excess & Surplus) business unit, helping to deliver on AXA XL Claims value in the marketplace and managing claims-related service issues for our customers, Third Party Administrators ("TPA") and key distribution partners. 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.
Complex Claims Consultant - Lawyers Professional Liability (Large Law) CNA Financial Corp.Complex Claims Consultant - Lawyers Professional Liability (Large Law)Boston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex professional liability claims, with 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.
Blended Claims Specialist, Construction CNA Financial Corp.Blended Claims Specialist, ConstructionBoston, 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.
Claims Consultant, Life Sciences CNA Financial Corp.Claims Consultant, Life SciencesBoston, 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 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 complex manage litigation and authorizing payments within scope of authority.
Claims Negotiation Manager CVS Health CorpClaims Negotiation ManagerMA$66,330–$145,860 / yearDemonstrated expertise in the No Surprises Act (NSA), out-of-network reimbursement methodologies, provider billing practices, and healthcare claims adjudication, with the ability to interpret complex regulations, evaluate claim and reimbursement disputes, guide negotiation strategies, ensure compliance, and drive favorable financial and operational outcomes. Lead daily negotiation operations while partnering closely with Product, Operations, Compliance, Analytics, and Client teams to enhance negotiation strategies, support product development, drive operational excellence, and ensure compliance with federal and state regulations.
Data Scientist Integrated Resources, IncData ScientistCambridge, MassachusettsContractorWorking knowledge of relevant national healthcare systems, specifically with large observational and insurance claims databases, experienced with diagnostic, procedure, and pharmaceutical coding systems. The responsibilities will also include: Analyze, design, develop, test, implement, validate, document, and maintain effective and efficient SAS programs for conducting, analyzing and reporting observational database studies.
Senior Program Manager / Project Manager - Medicaid Claims CVS HealthSenior Program Manager / Project Manager - Medicaid ClaimsMassachusettsResponsible for implementing best practices, facilitating workstreams through change, and ensuring effective delivery of projects and initiatives that enhance provider experience. Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Medicaid program, supporting all lines of business.
Pharmacy Technician Non-Certified Costco Wholesale CorporationPharmacy Technician Non-CertifiedSHARON, MassachusettsAssists Pharmacists in filling prescriptions by bringing stock bottles, counting, pouring, re-stocking, labeling, and pricing prescriptions under direct Pharmacist’s supervision. Answers phones and provides prompt and courteous member service including answering questions at pharmacy windows, directing members to product location.
Claims Consultant - Surety (Hybrid) Intact InsuranceClaims Consultant - Surety (Hybrid)Boston, MA$143,000–$167,000 / yearFor candidates located in San Francisco, CA; Washington DC; our Massachusetts based offices and the New York City metro area, the base salary range is $143,000 - $167,000. Some of the Claim Consultant responsibilities include but are not limited to: Makes timely and appropriate contacts and completes appropriate level of investigation to make determination of coverage, liability and damages for very complex and specialized claims.
Senior Claims Consultant/Director (00553) PMA ConsultantsSenior 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.
Senior Provider Experience Program Manager - Healthcare Claims CVS Health CorpSenior Provider Experience Program Manager - Healthcare ClaimsMA$106,605–$284,280 / yearWhat you will do: Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Provider Experience / Provider NPS program, supporting all lines of business. Drive Agile delivery of Provider Experience / Provider NPS initiatives, supporting business process and technology improvements across multiple lines of business.
Commercial Auto Adjuster Safety Insurance Group, Inc.Commercial Auto AdjusterBoston, MAThe adjuster sets up the claim, investigates the accident or loss, determines coverage applicability or exclusions, makes a liability and deductible decision, applies the appropriate surcharge when applicable and processes payments of both direct and subrogation claims. Conveniently located in the heart of Boston's financial district, our downtown office is a positive space where employees can stay connected to both each other and the pulse of the city.
NewSupervisor, Medicaid Claims Reviewer Mass General BrighamSupervisor, Medicaid Claims ReviewerSomerville, Massachusetts$79,560–$115,720.80 / yearWorking with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Bodily Injury Adjuster - Extended Handler Allstate Insurance CompanyBodily Injury Adjuster - Extended HandlerBoston, MA$50,000–$74,350 / yearAuto Insurance Claims, Automobile Accidents, Bodily Injury Claims, Case Management, Claims Administration, Claims Resolution, Claims Review, Insurance Claims Investigations, Insurance Coverage, Insurance Policies, Insurance Policy Review, Multitasking, Negotiation, Personal Injuries, Personal Injury Claims, Policy Interpretation, Prioritization, Soft Tissue, Soft Tissue Injuries, Task Management, Time Management. As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment.
Claims Review Specialist, DSNP Mass General BrighamClaims Review Specialist, DSNPSomerville, MassachusettsRemote$17.71–$25.28 / hourThe ideal candidate brings hands‑on experience with SCO and One Care claims processing and demonstrated proficiency in QNXT or similar claims adjudication systems (e.g., Facets).Essential Functions: Adjudicate claims to pay, deny, or pend as appropriate in a timely and accurate manner according to company policy and desktop procedure. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
NewUnrepresented Bodily Injury Adjuster Allstate Insurance CompanyUnrepresented Bodily Injury AdjusterMA$53,500–$77,800 / yearThe ideal candidate will possess strong analytical, communication, and decision-making skills, with a proven ability to navigate complex claim scenarios while delivering a positive customer experience and achieving quality claim outcomes. Successful candidates will have experience handling casualty injury claims, conducting thorough coverage investigations, negotiating settlements, and maintaining full ownership of claims throughout the life cycle.
Claims Consultant - Ocean Marine (Hybrid) Onebeacon Professional Insurance IncClaims Consultant - Ocean Marine (Hybrid)Canton, MA$143,000–$167,000 / yearWe currently have an opportunity for a Claim Consultant to join our Ocean Marine team based in our Plymouth, MN; Canton, MA; New York City, NY; Chicago, IL; Naperville, IL; Barrington, IL; Alpharetta, GA; Irvine, CA; Southfield, MI office on a hybrid schedule. In return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society.
Senior Claim Benefit Specialist - Remote CVS Health CorpSenior Claim Benefit Specialist - RemoteMARemote$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.