NewClaims Representative RedionClaims RepresentativePembroke Pines, FLPrimary responsibilities include efficient adjudication of insurance claims, both phone and written communication with insureds, travel suppliers, medical facilities, and others, as well as maintaining all state Department of Insurance regulations for claims files. From assisting with emergency medical claims to guiding customers through trip disruptions or ID theft, your work helps turn travel challenges into stories of resilience.
Claims & Denials Analyst LawallClaims & Denials AnalystClaims & Denials Analyst - full-time - in-office - Langhorne, PA - M-F, 8am to 4:30pm We’re a fast-growing, employee-friendly prosthetics and orthotics company seeking a Claims & Denials Analyst to join our dedicated team in Langhorne. This is a great opportunity for someone with a positive attitude, strong attention to detail, and some experience with health insurance claims—especially if you’re eager to learn and grow in a meaningful healthcare environment.
Individual Disability Claims Specialist II MetLife IncIndividual Disability Claims Specialist IITampa, FL$60,000–$70,000 / 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. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
NewPrior Authorization Technician I AmeriHealth CaritasPrior Authorization Technician INewtown Square, PARemoteCurrent/recentPharmacy Benefit Manager (PBM), managed care, hospital pharmacy, long-term care (LTC) pharmacy, home infusion pharmacy, and/or retail pharmacy experience preferred. For more than 15 years, our focus has been on providing optimal service through a clinical culture which seeks to provide members with high quality care while ensuring our partners receive favorable costs.
MRSGM NA Logistics Claims Manager - First Party Munchener Ruckversicherungs-Gesellschaft Aktiengesellschaft (Munich Re)MRSGM NA Logistics Claims Manager - First PartySchaumburg, ILWe are in search of an experienced insurance professional responsible for investigating, evaluating, and settling complex cargo damage claims by examining policies, gathering evidence, analyzing loss details, negotiating settlements with involved parties, and ensuring compliance with company guidelines, often handling high-value or intricate claims with a focus on minimizing losses; requiring strong knowledge of cargo insurance policies, shipping regulations, and claims handling procedures. Complex Claim Management - Leading the handling of large or complex cargo claims involving multiple parties, legal disputes, or significant financial exposure.
Reassessment Sr. Long Term Disability Claims MetLife IncReassessment Sr. Long Term Disability ClaimsNY$58,000–$69,000 / 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. The Reassessment Senior LTD Claims Specialist is responsible for evaluating and managing ongoing long-term disability claims to ensure accurate, timely, and customer-focused claim decisions that support MetLife's commitment to making a meaningful impact in the lives of our customers and communities across the United States.
Associate Claims Adjuster, Workers Compensation Liberty Mutual Holding Company IncAssociate Claims Adjuster, Workers CompensationWestborough, MAAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves as necessary, during the processing of the claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate. In this role, you'll manage a caseload of routine to moderately complex claims, making key decisions on compensability, evaluating losses, and negotiating fair outcomes.
Technical Claims Specialist - PN: 20069293 State of OhioTechnical Claims Specialist - PN: 20069293albany, OHAbility to: interpret extensive variety of technical & complex material in verbal & written forms; prepare & deliver professional presentations before specialized audiences & public; develop complex reports pertaining to claims, risk, safety & hygiene, medical & managed care; handle highly confidential & sensitive matters with all contacts; strategize for optimum efficiency; practice innovation & be creative in a government environment; delegate appropriately; identify & manage staff performance variances; direct programs; use statistical analysis; analyze customer satisfaction. Major Worker Characteristics: Knowledge of: policies & procedures related to claims operations, risk, safety & hygiene, loss prevention, medical and managed care; state & federal laws governing workers' compensation; management; labor relations; manpower planning; public relations; government structure & process (BWC) ; interviewing; BWC laws ; budgeting; training; loss-prevention principles; BWC programs*; OSHA compliance.
Claims Auditor Senior Elevance HealthClaims Auditor SeniorMendota Heights, MinnesotaThe Claims Auditor Senior is responsible for pre and post payment and adjudication audits of high dollar claims across multiple lines of business, claim types and products including complex specialized claims within Service Experience. We 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.
Epic HB/PB Resolute Claims Analyst InterscriptsEpic HB/PB Resolute Claims AnalystChantilly, VirginiaWe are seeking an experienced Epic Resolute Hospital Billing (HB),or Professional Billing (PB), and Claims Analyst to support, maintain, and optimize Epic Revenue Cycle applications. The ideal candidate will have hands-on experience with Epic Resolute HB, PB, Claims, and Revenue Cycle workflows, along with strong analytical and troubleshooting skills.
Claims Specialist, L1 ( Bilingual, Spanish Preferred) SonsioClaims Specialist, L1 ( Bilingual, Spanish Preferred)ColoradoWith a comprehensive lineup of Vehicle Protection plans, Sonsio offers industry-leading programs that cover Tire Road Hazard Protection, Appearance, Parts & Labor Warranties, Mechanical Advisory, and other critical consumer services. The Claims Specialist (Level 1) is responsible for accurately and efficiently processing the intake of new claims requests, while providing outstanding customer service to contract holders, dealers, and repair facilities.
Stop Loss Claims Resolution Consultant Sun LifeStop Loss Claims Resolution ConsultantKansas City, Missouri$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.
Eligibility Processor Integrated Resources, IncEligibility ProcessorMaryland Heights, MissouriContractorRequirements/Certifications:Minimum of 1 year customer service, claims, or general office experienceProficient with MS Office software. Has high degree of contact with Case Managers, Client Contacts, and providers.
Stop Loss Claims Specialist Marsh & McLennan Companies IncStop Loss Claims SpecialistConshohocken, PA$57,738–$65,000 / yearThe primary role of the Stop Loss Claims Analyst role is to manage the stop loss claims process for the MMA Stop Loss Center of Excellence including establishing the claims submission process in accordance with vendor processes, overall tracking and auditing to assure timely payment of eligible stop loss claims managed by the Center of Excellence. REQUIRED EDUCATION AND EXPERIENCE: Minimal of High School Graduate with Associate's Degree in Risk Management & Insurance, Actuarial Science, Mathematics and/or other related field is preferred or equivalent experience preferred; Minimum of two years prior work experience the Benefits Brokerage, Consulting, or Insurance industry; Strong background in self-funding, stop loss or claims administration required.
Claims Manager - Trucking (APD) ReservClaims Manager - Trucking (APD)Atlanta, GAFounded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success.
Associate Claims Examiner Kinsale ManagementAssociate Claims ExaminerRichmond, Virginia$70,000–$73,000 / yearWe’re known for our innovative, high-quality approach to specialty insurance — helping clients navigate complex risks across Property, Casualty, and Specialty lines in all 50 states. You’ll develop hands-on expertise in evaluating and resolving commercial insurance claims under the guidance of experienced Claims Supervisors.
NewClaims Service Specialist Marsh McLennanClaims Service SpecialistBroomfield, Colorado$62,400–$132,900 / yearOffice-based teams will identify at least one “anchor day” per week on which their full team will be together in person.#ICATThe applicable base salary range for this role is $62,400 to $132,900.The base pay offered will be determined on factors such as experience, skills, training, location, certifications, education, and any applicable minimum wage requirements. Founded in 1998 and based in Broomfield, Colorado, ICAT is a subsidiary of Victor and a leading provider of property insurance protection to homeowners and businesses located in hurricane- and earthquake-exposed regions of the United States.
Manager Claims Healthcare VillageCareManager Claims HealthcareNew York, NY$118,135.58–$132,902.53 / yearExperience: This position requires a minimum of 5 + years' experience in claims analytics performing increasingly complex data analysis and report/dashboard development, in a healthcare setting, and at least 2 years' experience managing and training staff. VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services.
$19.22/HR Claims Adjusters, Examiners & Investigators Moore Healthcare group$19.22/HR Claims Adjusters, Examiners & InvestigatorsFort Lauderdale, FLEutis Staffing is seeking detail-oriented and motivated Claims Adjusters, Examiners, and Investigators to join a dynamic team in Fort Lauderdale, Florida. This position offers hands-on experience reviewing claims, conducting investigations, analyzing documentation, and ensuring compliance with established policies and procedures.
Claims Law Firm Junior Analyst American International GroupClaims Law Firm Junior AnalystAtlanta, GADocumentation and website updates, keeping business facing documents / webpages which reflect AIG's commercial positions with Law Firms accurate and current; Assist Claims Law Firm Managers in handling law firm inquiries and provide support to internal Claims stakeholders as necessary, including performing searches/queries via AIG's e-billing and law firm management platform and monitoring team's inbox. Key responsibilities: Support Claims Law Firm Managers with spend data analysis, data queries, and reporting, which support line of business Law Firm strategies or complex / high value Law Firm negotiations; Participate in end to end acquisition of smaller Law Firms with an annual spend of less than $500K for Insurance Claims processing and adjudication commodities.