Claims Representative I (South Portland, ME & Roanoke, VA) Elevance HealthClaims Representative I (South Portland, ME & Roanoke, VA)South Portland, MaineWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Stop Loss Claims Resolution Consultant Sun Life Financial IncStop Loss Claims Resolution ConsultantPortland, ME$54,100–$81,200 / yearThis role combines deep technical expertise as a Stop Loss Health Claims Analyst with responsibility for managing end-to-end inquiry resolution, including research, claim determination support, documentation review, and clear customer communication. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Sr. Claims Analyst, Health And Risk Solutions Sun Life FinancialSr. Claims Analyst, Health And Risk SolutionsPortland, ME$68,200–$102,300 / yearYou will also play a key role in managing internal and external relationships, supporting new hire training, and coaching and mentoring Health and Risk Solutions Claim Analysts and Overpayment Specialists. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Sr. Claims Analyst, Health and Risk Solutions Sun Life Financial IncSr. Claims Analyst, Health and Risk SolutionsPortland, ME$68,200–$102,300 / yearYou will also play a key role in managing internal and external relationships, supporting new hire training, and coaching and mentoring Health and Risk Solutions Claim Analysts and Overpayment Specialists. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Claims Negotiation Manager CVS Health CorpClaims Negotiation ManagerME$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.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeMEEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
LTD Claims Examiner II Reliance Standard Life Insurance CompanyLTD Claims Examiner IISouth Portland, MaineRemote$52,450–$65,570 / yearReviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. The successful candidate’s starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistME$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.
NewAssociate Claim Specialist Opportunities at MEMICAssociate Claim SpecialistPortland, MEIn this role, you will investigate, evaluate, and manage medical-only and low-complexity lost time claims, ensuring injured workers receive appropriate care and benefits while supporting policyholders and agents. Ongoing Learning : Stay updated on state laws and workers’ compensation trends through MEMIC-provided training and external certifications like WCP or Claims Law (AEI).
NewAssociate Claim Specialist MEMICAssociate Claim SpecialistPortland, MEIn this role, you will investigate, evaluate, and manage medical-only and low-complexity lost time claims, ensuring injured workers receive appropriate care and benefits while supporting policyholders and agents. Ongoing Learning : Stay updated on state laws and workers’ compensation trends through MEMIC-provided training and external certifications like WCP or Claims Law (AEI).
NewClaim Specialist I Opportunities at MEMICClaim Specialist IPortland, ME$60,000–$70,000 / yearIf so, we invite you to join our team as a Claim Specialist I .In this role, you'll play a critical part in helping injured workers navigate the claims process while partnering with employers, agents, medical providers, and legal professionals to deliver fair, timely, and compassionate claim resolutions. For over 30 years, we’ve been a leader in helping businesses protect their employees and reduce workplace injuries while delivering exceptional claims services.
EPL & D&O Liability Associate Claim Counsel The Travelers Companies IncEPL & D&O Liability Associate Claim CounselSouth Portland, ME$89,800–$148,300 / yearTravelers'' Private/Non-Profit Team provides executive and organizational management liability coverage to privately held companies and non-profit entities of all types and sizes as well as certain governmental public entities. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies.
EPL & D&O Liability Claim Counsel The Travelers CompaniesEPL & D&O Liability Claim CounselSouth Portland, ME$111,600–$184,200 / yearTravelers' Private/Non-Profit Team provides executive and organizational management liability coverage to privately held companies and non-profit entities of all types and sizes as well as certain governmental public entities. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies.
Claim Specialist I MEMICClaim Specialist IPortland, ME$60,000–$70,000 / yearIf so, we invite you to join our team as a Claim Specialist I .In this role, you'll play a critical part in helping injured workers navigate the claims process while partnering with employers, agents, medical providers, and legal professionals to deliver fair, timely, and compassionate claim resolutions. For over 30 years, we’ve been a leader in helping businesses protect their employees and reduce workplace injuries while delivering exceptional claims services.
Auto Adjuster I, II or Sr. Allstate Insurance CompanyAuto Adjuster I, II or Sr.ME$50,000–$74,350 / yearAuto Collision (Inactive), Auto Collision Repair, Auto Insurance, Auto Insurance Claims, Automobile Accidents, Automobile Liability, Case Management, Claims Administration, Claims Resolution, Claims Review, Customer Service, De-Escalation, Insurance Administration, Insurance Claims, Insurance Coverage, Insurance Policies, Investigative Skills, Multitasking, Negotiation, Task Organization, Time Management. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Bodily Injury & Homeowners Liability Adjuster Allstate Insurance CompanyBodily Injury & Homeowners Liability AdjusterME$53,500–$86,400 / yearAuto Insurance Claims, Case Management, Casualty Insurance, Casualty Management, Claims Administration, Claims Resolution, Claims Review, Commercial Liability, De-Escalation, Home Insurance, Homeowners Claims, Homeowners Insurance, Homeowners Insurance Claims, Insurance Policies, Liability Insurance, Liability Management, Litigation, Multitasking, Personal Injury Claims, Property & Casualty Insurance, Relationship Management, Tort Liability. Team members may have the opportunity to gain exposure to a variety of claim types and handling responsibilities, including extended handling, litigation, and homeowners liability claims, based on business needs, performance, and development goals.
Surveillance Investigator Allied UniversalSurveillance InvestigatorPortland, MaineThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Commercial Insurance Analyst - Remote CSAA Insurance GroupCommercial Insurance Analyst - RemoteMERemote$122,850–$136,500 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - 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, Nebraska - Home Teleworkers {+ 20 more}. Pursuit or completion of industry-relevant continuing education, including graduate degrees, MBS, risk and insurance designations from The Institutes (AINS, AIC, ARM, CPCU, etc.), or actuarial exams and designations (ACAS, FCAS, CERA).
NewLarge Loss Bodily Injury Adjuster Allstate Insurance CompanyLarge Loss Bodily Injury AdjusterME$85,000–$145,075 / yearAnalytical Thinking, Bodily Injury Claims, Client Counseling, Collaboration, Complex Claims, Conflict Management, Industry Trend Analysis, Large Loss Claims, Litigation, Negotiation, Personal Injury Claims, Prioritization, Risk Mitigation, Tender Responses, Time Management, Torts. Works with Product, Protection, Law, and Claims on new products introduced to the Field and the sales force, and develops Claim Bulletins to provide new forms and/or endorsements that impact claim handling practices.
Investigator Ethos Risk Services LLCInvestigatorPortland, MEREQUIREMENTS: Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients.