Senior Business Analyst, Claims and Vendor Data EmblemHealth IncSenior Business Analyst, Claims and Vendor DataNew York, NY$68,040–$118,800 / yearProven ability to apply quantitative and/or qualitative research and data analysis techniques to improve operational processes; and to identify and interpret trends, patterns, and anomalies within complex datasets of trend information required. Analyze and interpret claims, payment, and vendor data to identify, prevent, and recover overpayments, as well as to drive process improvements and cost containment.
Senior Claims Specialist, Cyber AXA SASenior Claims Specialist, CyberNEW YORK, NY$117,000–$184,400 / yearCoordinating 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.
Claims Specialist, Cyber AXA SAClaims Specialist, CyberNew York, NY$83,500–$145,500 / yearCoordinating 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.
IDI Claims Business Procedures Consultant MetLife IncIDI Claims Business Procedures ConsultantNY$54,000–$72,000 / yearRecognized on Fortune magazine\''s list of the "World\''s Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. 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 strengthen operational consistency, support risk mitigation, and partner across Claims, Reinsurance, Finance, Technology, and Audit to improve processes that directly support MetLife's customers and business performance.
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.
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.
NewClaims Consultant -Life Sciences or Cyber/Technology E&O (Hybrid) Intact Specialty SolutionsClaims Consultant -Life Sciences or Cyber/Technology E&O (Hybrid)New York, New YorkSpecial 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.
Senior Claim Specialist - Prime Specialty CRC Insurance Services, LLCSenior Claim Specialist - Prime SpecialtyNew York, NY$120,000–$140,000 / yearEvaluate claims, reporting forms and cancellations and initiate necessary corrections to ensure accuracy of dates, coverage, signature, commission, premium, attachments, etc. General Description of Available Benefits for Eligible Employees of CRC Group: At CRC Group, we're committed to supporting every aspect of teammates' well-being physical, emotional, financial, social, and professional.
Remote Claims Representative - 609986 Metro Public AdjustmentRemote Claims Representative - 609986New 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.
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.
Claims Representative 595635 Metro Public AdjustmentClaims Representative 595635Edison, 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.
Cyber Claims Counsel At-Bay IncCyber Claims CounselNew York, NY$120,000–$150,000 / yearDesire to have an impact far deeper than just the claims that you manage by collaborating across the company to understand the risks our insureds face and consistently improve our underwriting technology and products. With 98% of cyber insurance claims in the past five years coming from small and mid-size businesses with revenue under $2B, providing an integrated solution to help manage risk is more critical than ever.
Managing Director Strategic Claims Oversight - Healthcare Severity CNA Financial Corp.Managing Director Strategic Claims Oversight - Healthcare SeverityTarrytown, NY$97,000–$189,000 / yearDevelops and maintains collaborative working relationships with internal and external business partners including Operations, Underwriting, Actuary and Risk Control and regularly shares claims outcomes, trends, legal developments and other relevant business updates. Responsible for the ongoing management of staff by attracting talent, setting clear direction, providing appropriate guidance, managing performance, recognizing contributions, and developing capabilities.
Coverage & Complex Claims Lead Selby Jennings LtdCoverage & Complex Claims LeadMorristown, NJContribute to TPA oversight through training, audits, and best practice sharing, and support key proceedings such as mediations and trials while maintaining required licensing. This role will be responsible for handling bad faith suits filed against the major case unit while working heavily with coverage counsel and legal.
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.
General Liability Claims Consultant CNA Financial Corp.General Liability Claims ConsultantWarren, NJ$72,000–$141,000 / yearThis individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line(s) of business. Performs a combination of duties in accordance with departmental guidelines: Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.
Claims & Litigation Associate (Remote) Stanford Health CareClaims & Litigation Associate (Remote)NYRemote$100.03–$132.51 / hourInvestigates pre-suit claims, reviews medical records, interviews providers, retains consultants when necessary, communicates with patients and/or families, and directly negotiates settlements when warranted. Oversees legal defense strategy, retains outside counsel, coordinates support for investigation, reviews attorney invoices, and monitors counsel's compliance with litigation management guidelines.
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.