Claims Negotiation Analyst (Out of Network Mandates) Horizon Healthcare ServicesClaims Negotiation Analyst (Out of Network Mandates)Newark, New JerseyPrepares 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. $58,029 - $77,074 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.
Claims Support Advocate (Temp) Included Health IncClaims Support Advocate (Temp)NYFor context, these markets include Zone A (e.g., Phoenix AZ, San Antonio TX, Columbus OH, Charlotte NC), Zone B (e.g., Chicago IL, Denver CO, San Diego CA, Houston TX), and Zone C (e.g., Los Angeles CA, Seattle WA, Washington, D.C., Boston MA). Job Summary: As a Claims Support Advocate (CSA), you will be part of a vibrant team of high performing and highly engaged professionals that work to ensure a quality member experience within our service level agreements.
Claims Operations Specialist - HYBRID DB Insurance Co., Ltd.Claims Operations Specialist - HYBRIDGreat Neck, NY$70,000–$100,000 / yearBacked 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.
Actuary / Senior Actuary At-BayActuary / Senior ActuaryNew York, NY$150,000–$185,000 / yearYou'll be surrounded by a team that loves what they do, leverages technology to improve efficiency & minimize duplicative work, and recognizes the enormous responsibility that they have - to support key business decisions with data backed insights and a deep understanding of insurance risk. You will be responsible for driving At-Bay's professional lines product related initiatives and lead a wide variety of pricing projects, from inception to implementation, to understand the impacts and implications of pricing and underwriting initiatives on the business.
Actuarial Manager, Pricing At-BayActuarial Manager, PricingNew York, NY$175,000–$205,000 / yearAs an Actuarial Manager on the Pricing team, you will be working under the risk function with talented team members in modeling, risk analytics, decision engine, insurance and tech product. Identify, advise and execute pricing initiatives to achieve functional strategies (often segment specific) on matters of significance, and present proposed initiatives to senior management.
Complex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial Corp.Complex Claims Consultant/Specialist - Lawyers Professional LiabilityNew York, NY$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.
NewDirector, Product Management — AI Claims Platform CB Smart RecruitDirector, Product Management — AI Claims PlatformNew York, New YorkRemote$200,000–$230,000 / yearCandidates whose experience is primarily BI/dashboard product management, high-level GenAI strategy without shipped products, transformation/program management without roadmap ownership, or healthcare without AI/automation/product ownership would not align closely with the requirements. The organization is developing a platform designed to help claims teams review claims more accurately and efficiently by using AI to understand policies, claims data, business rules, and operational workflows and provide decision support around whether claims should be approved, denied, adjusted, or escalated.
Senior Analyst, Internal Audit Roc Nation Sports LLCSenior Analyst, Internal AuditNew York, NY$92,000–$115,000 / yearYou will scrutinize outside counsel invoices for accuracy and compliance with billing guidelines, coordinate directly with insurance carriers and brokers to recover covered costs, and provide analytical support for internal contract review and internal audit initiatives. The Role: Roc Nation is seeking a detail-oriented finance professional to own the review of revenue contracts and management of the company's legal spend and lead the recovery of eligible legal expenses through insurance claims.
Claims Manager, SDI AXA SAClaims Manager, SDIMorristown, NJ$139,300–$219,300 / yearClaims Manager - SDI Chicago, IL | Hartford, CT | Exton, PA | New York, NY | Morristown, NJ| Boston, MA | USA As the SDI Claims Manager, you will play a pivotal role in leading a team that handles high-exposure Subcontractor Default Insurance (SDI) claims for some of the largest construction contractors in the industry. 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.
Adjuster Claims Representative - 11717 Metro Public AdjustmentAdjuster Claims Representative - 11717Newark, NJIf 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. Metro Public Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim.
Remote Claims Representative - 11717 Metro Public AdjustmentRemote Claims Representative - 11717Newark, NJRemoteIf 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. Metro Public Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim.
Remote Claims Representative 629550 Metro Public AdjustmentRemote Claims Representative 629550New Brunswick, NJRemoteIf 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. Metro Public Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim.
Senior Claims Representative - 11717 Metro Public AdjustmentSenior Claims Representative - 11717Edison, NJIf 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. Metro Public Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim.
Complex Casualty Claims Consultant EMC Insurance Group Inc.Complex Casualty Claims ConsultantNY$112,276–$161,326 / yearClaims business partner for the Casualty Claims Department: Collaborates with the Claims Compliance and Quality Assurance team and Complex Casualty Claims Director to provide ongoing support for casualty claim handling, including oversight and implementation of best practices for the casualty team members. Serves as the point person to monitor progress on complex casualty claims audit action plan items implemented by the Complex Casualty Claims leadership and works closely with these parties to report to the Complex Casualty Claims Director.
Sr. Claims Counsel, Miscellaneous Professional Lines Sompo InternationalSr. Claims Counsel, Miscellaneous Professional LinesMorristown, NJ$125,000–$175,000 / yearSalary Range: $125,000-$175,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Sr. Claims Counsel, Miscellaneous Professional Lines Sompo International Holdings LimitedSr. Claims Counsel, Miscellaneous Professional LinesGarden City, NY$125,000–$175,000 / yearSalary Range: $125,000-$175,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Workers Compensation Claims Specialist (NE Region) Zurich Insurance Group LtdWorkers Compensation Claims Specialist (NE Region)Parsippany, NJRemoteThis position offers a hybrid work schedule from our Parsippany or Boston offices, or a fully remote setup based in one of the following states: Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, or West Virginia. The Workers Compensation Claims Specialist will handle multi-party commercial line Workman's Compensation claims of low to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.
Occupational Accident Claims Specialist I Zurich Insurance Group LtdOccupational Accident Claims Specialist IParsippany, NJDesigned with our employees needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location while facilitating in-person connections and collaborative activities when meaningful and valuable. In this role you will be responsible for: Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims.
Customer Service Representative - State Farm Agent Team Member Kevin Baez - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberHillsborough, NJFull timeAs a Customer Service Representative - State Farm Agent Team Member with Kevin Baez - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Account Associate - State Farm Agent Team Member Liam Masterson - State Farm AgentAccount Associate - State Farm Agent Team MemberGarden City, NYFull timeROLE DESCRIPTION: As Account Associate - State Farm Agent Team Member for Liam Masterson - State Farm Agent, you are vital to our daily business operations and customers’ success. We are located in Garden City, NY and help customers with their insurance and financial services needs, including: Auto insurance.