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  • Insurance Claims Specialist

    Marubeni America Corporation 4.6company rating

    Claim processor job in New York, NY

    To be considered, please apply through the link here. We are seeking an experienced and independent Insurance Claims Specialist with 7+ years of multi-line claims experience to manage and resolve claims across Marine Cargo, Property & Casualty, Automobile, Workers' Compensation, and Liability/Litigation. The role also supports contract reviews by assessing insurance-related provisions to ensure alignment with policy coverage and claims protocols. The ideal candidate will also provide support to the Insurance Manager and General Manager on special insurance projects as needed, contributing to broader departmental goals and demonstrating flexibility beyond core claims duties. ESSENTIAL JOB DUTIES: Manage the end-to-end claims process for: -Marine cargo/inland transit -Commercial property and general liability -Automobile (fleet and HNOA) -Workers' Compensation (“WC”) -Litigated liability claims, including bodily injury and third-party property damage Handle end-to-end claims for marine, property, liability, auto (fleet/HNOA), WC, and litigated matters including bodily injury and third-party property damage. Review policies to assess coverage, exclusions, deductibles, and retentions Coordinate with brokers, carriers, adjusters, and Internal legal counsel Support contract review by evaluating insurance clauses (limits, AI, Waiver of Subrogation) and identifying potential risk/coverage gaps Draft claim notifications and ensure compliance with policy timelines Provide loss history, reserve, and claim summaries to assist with renewal preparation Collaborate with Legal, MGC, and MAC BU Operations to resolve claims Participate in claim reviews and strategic discussions in recovery efforts Support the GM and Insurance Manager with special insurance-related projects as needed, and demonstrate flexibility in cross-functional assignments. MINIMUM EDUCATION REQUIREMENTS: Bachelor's degree in insurance or business-related fields or equivalent experience. MINIMUM EXPERIENCE AND CAPABILITY REQUIREMENTS: 7+ years of insurance claims experience across multiple P&C lines, including marine and litigated claims. Strong working knowledge of insurance policy language, ISO forms, and manuscript policies. Familiarity with contractual risk transfer principles and ability to analyze insurance-related clauses. Experience coordinating with external counsel and adjusters on complex/litigated claims. Proficiency in claims systems, Microsoft Word and Excel, and document management platforms. Technically skilled in both claims handling and policy interpretation. Detail-oriented with excellent judgment and risk awareness. Confident in reviewing contract language from an insurance perspective. Collaborative and able to communicate effectively with both technical and non-technical stakeholders. Able to manage competing priorities and operate independently. Must have the ability to work with deadlines and work in a fast-paced and dynamic work environment. Requires excellent written and verbal communication skills. Must be able to work in a multi-cultural business environment. JOB-RELATED CERTIFICATION: CPCU, ARM, or AIC designation preferred
    $46k-71k yearly est. 4d ago
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  • Auto Claims Representative

    Beacon Hill 3.9company rating

    Claim processor job in Boston, MA

    Auto Claims Representative to $47K - Lauch Your Career! Our client, a leading insurance organization, is seeking an Auto Claims Representative to manage automobile property damage claims while delivering exceptional customer service. As part of a growth-oriented training program, you'll investigate claims, assess liability, and ensure timely resolution. Position Details: Location: Boston, MA Work Model: Hybrid Degree: Preferred Responsibilities include analyzing policy provisions to determine coverage; investigating auto accidents and gathering documentation; negotiating and settling claims within authority limits; maintaining accurate records and follow-up systems; coordinating with vendors and internal teams to resolve disputes; initiating subrogation processes when applicable; and managing phone and email communications to ensure timely updates. The ideal candidate possesses strong organizational and multitasking skills; excellent verbal and written communication abilities; proficiency in Microsoft Office Suite; ability to handle sensitive situations with professionalism; and a customer-focused mindset with adaptability to manage multiple priorities. Enjoy a role that offers comprehensive benefits, long-term career growth, and a supportive team environment committed to your success! Beacon Hill is an equal opportunity employer and individuals with disabilities and/or protected veterans are encouraged to apply. California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: ***************************************** Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records. Company Profile: Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement. Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs. Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting ************* Benefits Information: Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility. Upon successfully being hired, details will be provided related to our benefit offerings. We look forward to working with you. Beacon Hill. Employing the Future (TM)
    $47k yearly 4d ago
  • Medical Claims Processor

    Vanguard Group Staffing, Inc.

    Claim processor job in New York, NY

    Long Term Temporary, Possible Temporary- to -Direct Hire Medical Billing/Claims Coordinator - Monday through Friday, 9am to 5pm, Fully On-Site. Communicate via telephone and written correspondence with providers, members, attorneys, and collection agencies to resolve balance billing/fee negotiation inquiries. Handle large call volume. Negotiate and resolve balance billing inquires, negotiate fees and discounts for members with nonparticipating providers to reduce out of pocket expenses. Analyze correspondence; verify member eligibility, claim history and coordination of benefits. Review claims to determine if appropriate action was taken; follow up with Claims and Recovery Units to initiate adjustments and recover money. Identify billing anomalies and alert the Fraud and Abuse Department to reduce fraudulent billing practices. Triage balance billing/fee negotiation inquiries and ensure all documents are processed in a timely and efficient manner. Research provider contracts and lease network reports to ensure providers are not breaching contracts by referring members out of network. Perform additional duties and projects as assigned by management.
    $39k-50k yearly est. 1d ago
  • Specimen Processor-- DAVDC5708042

    Compunnel Inc. 4.4company rating

    Claim processor job in Grafton, MA

    •Assist with laboratory testing to help diagnose various pet and other animal illnesses, injuries, and diseases; process specimens; help with a variety of laboratory tasks • Assist with lab inventory, procuring supplies, and stocking shelves. *Assist with moving samples around the lab, loading analyzers, and general lab maintenance and cleanliness • Support and maintain various processes, systems, and databases. • Perform recordkeeping ad data collection • Perform administrative duties such as answering phones and preparing parcel deliveries, files requisitions, and performs duties in support of billing, pricing, and sample transportation. What You Need to Succeed: • Ability to read and interpret documents such as safety rules, standard operating procedures (SOPs), material safety data sheets (MSDSs), operating and maintenance instructions, government rules and technical procedures. • Ability to prioritize and multi-task • Strong initiative and follow through • Attention to detail • Ability to work independently and as a team contributor • Must demonstrate a high level of customer service • Good computer skills: Microsoft Office and SAP preferred • You meet the physical requirements that go with working as a Lab Associate - May transport hazardous waste within the facility and may occasionally lift and move up to 25 pounds.
    $44k-54k yearly est. 4d ago
  • Claims Specialist, APH

    Swiss Re 4.8company rating

    Claim processor job in Armonk, NY

    Imagine a role where you can directly influence the profitability of a business, steer a diverse portfolio of claims, and build lasting relationships with clients. If you're a self-motivated individual who thrives on collaboration and career growth, this challenge is for you! If this sounds interesting, join us at Swiss Re, where we believe in fostering an environment that sparks the best ideas, maintaining a sensible work-life balance, and producing outstanding results through engaged employees. Together, we can help make the world more resilient. About the Role As a Reinsurance Claims Specialist at Swiss Re, you'll manage a portfolio of asbestos, pollution, and health hazard (APH) reinsurance claims across various lines of business for both active and runoff portfolios. This role offers a unique opportunity to collaborate across functions, develop broad knowledge about the insurance and reinsurance industry, and help steer the business through data-driven insights and strong client partnerships. Key activities of the role include: * Steer a diverse portfolio of multi-line reinsurance claims, ensuring strategic performance through data analysis and industry insight. * Analyze contractual obligations, establish and monitor reserves, and approve payments within authority to ensure timely, effective resolution. * Apply advanced data analytics and reporting tools to manage the portfolio and identify emerging trends. * Collaborate with Underwriting, Actuarial, and other teams to provide portfolio insights that inform business strategy and decision-making. * Formulate, develop, and implement account management, including building and supporting client relationships. * Participate in client meetings and audits to review claims, assess claims-handling practices, and support collaborative problem-solving. * Deliver high-quality claims and client service, sharing industry knowledge and contributing to continuous improvement initiatives. * Support internal stakeholders with research on claim topics, loss development, and contract wording issues, while ensuring compliance with governance, legal, and reporting requirements. About the Team You'll join a team of APH claims professionals known for deep technical expertise, collaborative spirit, and innovative problem-solving. We work closely with clients and internal partners to deliver exceptional claims management, identify potential exposures, and provide meaningful insights that shape our business. If you're curious, analytical, and motivated by teamwork and impact, this is the place for you. About You You excel in a dynamic environment, adept at juggling multiple priorities while maintaining professionalism. With strong interpersonal skills, you're confident communicating with clients, legal counsel, and senior management, and you bring curiosity and strategic thinking to every challenge. Additional requirements include: * Bachelor's degree required. * At least 2-5 years of experience in claims, underwriting, insurance, reinsurance, or insurance-related legal work, including handling latent direct insurance claims. * General understanding of and/or exposure to other insurance disciplines i.e., contract wording, accounting, underwriting. * Ability and passion to manage a complex portfolio with critical analysis and innovative strategic thought. * Confirmed ability to meet deliverables, implement plans, and conduct analysis. * Excellent writing skills and proficiency in MS Office tools, claims systems and the ability and willingness to learn new systems. * Excellent organizational and data analytics skills with openness for continued growth. * Ability and willingness to learn new claims handling systems. * Some business travel required. The estimated base salary range for this position in Kansas City, MO is $84,000 to $140,000; for Armonk, NY is $90,000 to $150,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation. About Swiss Re Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world. Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability. If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience. Keywords: Reference Code: 136396 Nearest Major Market: White Plains Nearest Secondary Market: New York City Job Segment: Claims, Compliance, Accounting, Actuarial, Data Analyst, Insurance, Legal, Finance, Data
    $90k-150k yearly 29d ago
  • Complex Liability Claims Specialist - Commercial General Liability

    Utica National Insurance Group 4.8company rating

    Claim processor job in New Hartford, NY

    The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an "A" rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required. Key responsibilities * Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in multiple jurisdictions. * Manage all claims in accordance with Utica National's established claim procedures. * Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level. * Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy. * Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims. * Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials. * Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle. * Achieve the service standard of "excellent" during all phases of claims handling. * Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction. * Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling. What you need * Four year degree or equivalent experience preferred. * Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims. * Proven experience negotiating claims and active participation in alternative dispute resolution practices. * Experience with general liability, additional insured considerations and complex coverage determinations. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary range: $103,300 - $140,000 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: * Medical and Prescription Drug Benefit * Dental Benefit * Vision Benefit * Life Insurance and Disability Benefits * 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) * Health Savings Account (HSA) * Flexible Spending Accounts * Tuition Assistance, Training, and Professional Designations * Company-Paid Family Leave * Adoption/Surrogacy Assistance Benefit * Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance * Student Loan Refinancing Services * Care.com Membership with Back-up Care, Senior Solutions * Business Travel Accident Insurance * Matching Gifts program * Paid Volunteer Day * Employee Referral Award Program * Wellness programs Additional Information: This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1
    $103.3k-140k yearly 28d ago
  • Trucking Claims Specialist

    Guard Insurance Group

    Claim processor job in New York, NY

    Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service. Key Responsibilities * Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures. * Review and interpret policy language to determine coverage and consult with coverage counsel when needed. * Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies. * Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information. * Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts. * Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards. * Participate in file reviews, team meetings, and ongoing training to support continuous learning. Salary Range $95,000.00-$145,000.00 USD The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Qualifications * Minimum of 3 years of trucking industry experience. * Experience with bodily injury and/or cargo exposures. * Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices. * Strong analytical and negotiation skills, with the ability to manage multiple priorities. * Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism. * Possession of applicable state adjuster licenses. * Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
    $95k-145k yearly Auto-Apply 55d ago
  • Commercial Auto Claims Specialist

    IAT Insurance Group

    Claim processor job in Cheshire, CT

    IAT has an immediate need for a Commercial Auto Claims Specialist who can be located in one of the following IAT offices: Alpharetta, Georgia Virginia Beach, Virginia Cheshire, Connecticut Scottsdale, Arizona Naperville, Illinois Rolling Meadows, Illinois Omaha, Nebraska St. Petersburg, Florida Raleigh, North Carolina This role will handle complex commercial trucking claims covering the entire United States. The Claims Specialist is responsible for investigating the extent of the company's liability and will be responsible for handling injury claims from inception until conclusion of the claim, which could include attorney represented and litigation cases. This role works a hybrid schedule from any of the listed IAT office locations. The hybrid schedule reflects our values (thinking and acting like an owner, collaboration, and teamwork) as it requires working from the office with colleagues and other disciplines Monday through Wednesday, with the option of working Thursday and Friday remotely. Although there is preference for an individual to work in one of the above mentioned IAT offices, we will consider fully remote work for the ideal candidate. Responsibilities: Handles complex, high exposure Commercial auto claims Presents cases to Sr. Management for reserving and direction, as required by Claim Guidelines. Verifies/analyzes applicable coverage for the reported loss. Evaluates, negotiates, and authorizes settlements with all stakeholders within designated authority. Selects, directs and manages Vendors/Counsel including approval of defense budgets. Maintains resident/nonresident adjuster licenses as required. Travel as required to handle catastrophic claims, attend mediations and settlement conferences Perform other duties as assigned. Qualifications: Must Have: HS degree/GED with 5+ years of relevant claims experience Insurance Licenses to comply with state and IAT requirements Experience handling commercial claims Experience handling bodily injury claims Appropriate claims license Strong customer service skills Experience handling 3rd party claims Excellent knowledge of Microsoft Office Excellent oral and written communication skills to communicate internally and externally Excellent critical thinking and problem solving skills Excellent attention to detail and customer service skills Strong organizational and time management skills Ability to set priorities and multitask in a fast-paced environment To qualify, all applicants must be authorized to work in the United States and must not require, now or in the future, VISA sponsorship for employment purposes Preferred to Have: Associate/Bachelors degree Experience working in task-based claims systems Considerable experience handling litigated bodily injury claims Completion of AIC, CPCU, or other similar program All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We maintain a drug-free workplace and participate in E-Verify. Compensation: Please note, that the annual gross salary range associated with this posting is $47,230 - $102,780. This range represents the anticipated low and high end of the base salary for this position. The total compensation will include a base salary, performance-based bonus opportunities, 401(K) match, profit-sharing opportunities, and more. Actual salaries will vary based on factors such as a candidate's qualifications, skills, competencies, and geographical location related to this specific role. To view details of our full benefits, please visit ************************************************** IAT Insurance Group is the largest private, family-owned property and casualty insurer in the U.S. I nsurance A nswers T ogether is how we define IAT, in letter and in spirit. We work together to provide solutions for people and businesses. We collaborate internally and with our partners to provide the best possible insurance and surety options for our customers. At IAT, we're committed to driving and building an open and supportive culture for all. Our employees propel IAT forward - driving innovation, stable partnerships and growth. That's why we continue to build an engaging workplace culture to attract and retain the best talent. We offer comprehensive benefits like: 26 PTO Days (Entry Level) + 12 Company Holidays = 38 Paid Days Off 7% 401(k) Company Match and additional Profit Sharing Hybrid work environment Numerous training and development opportunities to assist you in furthering your career Healthcare and Wellness Programs Opportunity to earn performance-based bonuses College Loan Assistance Support Plan Educational Assistance Program Mentorship Program Dress for Your Day Policy All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We maintain a drug-free workplace and participate in E-Verify.
    $47.2k-102.8k yearly Auto-Apply 34d ago
  • Analyst (Graduate Hire 2026) - Medical (Boston)

    Prescient Healthcare Group

    Claim processor job in Boston, MA

    Analyst (Graduate Hire 2026) - Medical Important Dates: * Application Deadline: February 13, 2026 * Start Date Range: August - September 2026 Application & Recruitment Process As part of your application, please submit a cover letter addressing the questions below. Candidates who do not submit a cover letter with responses to these questions will not be considered. Cover Letter Questions: * Why are you interested in Prescient Healthcare Group? What attracted you to this role? * What are your top three attributes that will make you a successful consultant? * How many times have you practiced a case with a peer? * What interests you most about working in the life sciences and pharmaceutical industry, and how have your academic experiences, internships, or other relevant exposure prepared you for this role? Recruitment Timeline: * February 16- February 27: Selected candidates will complete an introductory interview with a member of our Talent Acquisition team * February 27: All candidates will be notified of next steps. * March 4th: Final in-person assessment day (behavioral + case interviews) To ensure availability, candidates are encouraged to tentatively block March 4th for the in-person interview day. About You Do you have a passion for: * Understanding tomorrows emerging therapeutic areas? * Unlocking the full potential of new therapies and shaping successful future therapies? * Understanding why healthcare professionals and patients behave the way they do, and applying this to medical, clinical, and commercial strategies? * Are you a highly motivated professional interested in being part of a new and exciting team, working with global healthcare and pharmaceutical clients across the full product life cycle? About Prescient Healthcare Group (PHG) Our goal is a simple one: we solve exciting, real-world pharma challenges that ultimately make a meaningful difference in patients' lives. PHG is a unique global biopharma, insight-led strategy consultancy. Our core focus is helping biopharmaceutical clients create clinical and commercial strategies that deliver groundbreaking new treatments for patients. With offices in ten major cities across the world, we are a truly global enterprise and are still growing fast, offering our people endless opportunities, supporting rapid personal and professional development. We work with industry leading companies across the full product life cycle, to help them unlock the full potential of their brands. About the Opportunity The role will be varied, giving you the opportunity to develop and hone new skills whilst improving your knowledge of the healthcare industry. You will receive exposure to a broad mix of projects - varied therapeutic areas, a range of client sizes, and domestic vs. global reach. This will enable you to get the experience to decide if you want to take a more specialized route as your career progresses. Our onboarding and training program will provide the support and development you need to hit the ground running; a mix of formal classroom training, shadowing colleagues on projects and 'on the job' coaching will equip you with the capabilities you need to succeed at Prescient. Key Responsibilities: * Exhibit high degrees of professionalism across each aspect of working life, demonstrating respect, integrity and support for colleagues and in our interactions with clients * Take pride in and full responsibility for meeting high levels of performance in work process and output; take charge of own professional development and proactively seek opportunities for growth * Demonstrate a strong willingness to learn and a 'can-do' attitude; showcase ability to gain expert status on a new topic and create an impact within the team and with clients * Demonstrate an ability to thrive in an environment through efficient planning * Demonstrate an ability and willingness to take risks, work in a non-hierarchical environment and take step-up/step-down roles to support strong outcomes * Act as a role model in line with company and client codes of ethics and processes; represent the company and promote its reputation to a high standard Desired Experience and Skills * Bachelors in a relevant field (e.g., Life Sciences, Biotechnology, Neuroscience, Pharmacology, Business, Economics, Marketing, or Psychology). * Demonstrated passion for the life sciences and pharmaceutical industry, supported by academic research, industry exposure, or relevant coursework. * Ability to rapidly synthesize, analyse, and apply new information, demonstrating intellectual agility and a proactive approach to problem-solving. * Exceptional verbal and written communication abilities, with a track record of delivering clear, concise, and impactful presentations and reports. * A drive for self-improvement - the best consultants are those that seek out and action on feedback to improve themselves. * Entrepreneurship - The ability to lead and drive outcomes, particularly in situations that have some ambiguity. * Consulting is a team sport so a demonstrated willingness and enthusiasm to collaborate with others is required. What We Offer * Highly competitive base salary plus performance-related bonus, 401K matching and Health & Dental benefits. * A strong values-based culture that promotes respect, inclusion and teamwork, encouragement to contribute and influence on the business - where everybody has a voice. * Leaders who are accessible, truly listen, are ambitious for our teams, and committed to coaching & sharing their expertise. * A high-growth, entrepreneurial environment where our thinking and our work are innovative, imaginative and bright. * Endless and tailored career development that stretches you and is based on your ambition, abilities and interests - not just box-ticking. * Flexible working, recognition for going the extra mile, and a flat hierarchy. More about Prescient Healthcare Group Prescient is a pharma services firm specializing in dynamic decision support and product and portfolio strategy. We partner with our clients to turn science into value by helping them understand the potential of their molecules, shaping their strategic plans and allowing their decision-making to be the biggest differentiating factor in the success of their products. When companies partner with Prescient, the molecules in their hands have a greater potential for success than the same science in the hands of their competitors. Founded in 2007, Prescient is a global firm with a footprint in ten cities across three continents. Our team of nearly 475 experts partners with 27 of the top 30 biopharmaceutical companies, the fastest-growing mid-caps and cutting-edge emerging biotechs, including some of the biggest and most innovative brands. More than 70% of our employees hold advanced life sciences degrees, and our teams deliver an impressive depth of therapeutic, clinical and commercial expertise. The annual full time base salary range for this role is ($75,000 - $85,000). Specific compensation is determined through interviews and a review of relevant education, experience, training, skills, geographic location and alignment with market data. Additionally, positions may be eligible to receive a discretionary bonus as determined by bonus program guidelines. Prescient offers PTO and paid holidays, the terms of which are set forth in the program policies. All full-time employees also are eligible to participate in various benefit plans, including medical, dental, vision, life, disability insurance and 401K; in each case in accordance with the terms of the applicable plans. Prescient has been a portfolio company of Bridgepoint Development Capital since 2021 and Baird Capital since 2017. For more information, please visit: ******************** We are an equal opportunity employer and fully comply with applicable legislation in all the geographies in which we operate. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable national, federal, state or local laws.
    $75k-85k yearly 4d ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim processor job in Glastonbury, CT

    Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
    $82.8k-97.3k yearly Auto-Apply 60d+ ago
  • Epic Medical Analyst

    Together We Talent 3.8company rating

    Claim processor job in New York

    Jamaica, NY (Onsite) | Direct Hire | $121,000-$150,000 | Hospital & Health Care | Information Technology Support the implementation, optimization, and ongoing maintenance of Epic EHR modules to improve clinical workflows and patient care across a healthcare organization. Position Overview We are seeking an experienced Epic Medical Analyst to support the build, maintenance, and optimization of Epic Electronic Health Record (EHR) modules. This role partners closely with clinical, administrative, and IT teams to ensure Epic applications are configured effectively, aligned to operational needs, and fully supported post -implementation. The ideal candidate brings hands -on Epic experience, strong analytical skills, and the ability to translate clinical and business requirements into scalable Epic solutions. This is a fully onsite role based in Jamaica, NY. Key Responsibilities Epic System Configuration & Support Configure, maintain, and optimize Epic modules to support clinical and operational workflows. Troubleshoot system issues and ensure optimal application performance. Support system upgrades, patches, and enhancements through testing and validation. Workflow Analysis & Optimization Analyze current clinical and administrative workflows to identify improvement opportunities. Partner with stakeholders to design and implement Epic -based solutions that enhance efficiency and patient care. Translate business and clinical requirements into system configurations and functional designs. User Training & Support Provide training and ongoing support to end users on Epic functionality and best practices. Respond to user inquiries and resolve application -related issues. Develop and maintain training materials, user guides, and documentation. Reporting, Testing & Quality Assurance Utilize Epic reporting tools to extract and analyze data for operational and quality improvement initiatives. Conduct system testing and quality assurance to ensure changes meet requirements and function as intended. Participate in process improvement initiatives to enhance system accuracy, efficiency, and usability. Collaboration & Communication Work closely with clinical, IT, and administrative teams to support implementation and ongoing optimization efforts. Ensure system requirements are clearly understood and effectively delivered. Requirements Required Qualifications Bachelor's degree in Computer Science, Healthcare Information Technology, Health Information Management, or a related field. Minimum of one year of hands -on experience building, maintaining, or supporting Epic modules. Strong understanding of healthcare operations and clinical workflows. Excellent communication, organizational, and problem -solving skills. Preferred Qualifications Epic Certification in relevant modules such as EpicCare Ambulatory, EpicCare Inpatient, or Clinical Documentation. Two or more years of Epic application experience. Preferred Tools & Skills Epic EHR applications and reporting tools Microsoft Office Suite Knowledge of HIPAA and healthcare data privacy regulations Strong analytical and troubleshooting skills Attributes & Mindset Detail -oriented with strong documentation skills. Able to manage multiple priorities in a complex healthcare environment. Comfortable collaborating with clinical, technical, and administrative stakeholders. Comfortable collaborating with clinical, technical, and administrative stakeholders.
    $39k-48k yearly est. 3d ago
  • Examiner

    TF CDL Testing Services LLC

    Claim processor job in Albany, NY

    The Examiner at CDL Schools administers CDL Skills Exams (vehicle inspection, basic control skills, road test) in accordance with state requirements and maintains proper documentation. Main Focus Area #1: Compliance Maintain your certification as a state CDL Examiner, to include submitting to a background check Properly document all tests and communicate challenges with state Testing Manager Complete annual co-scores as required with state monitoring agencies. Main Focus Area #2: Testing Maintain current CDL and DOT Physical Administer CDL Skills Tests in accordance with state requirements and scoring standards Ensure the SAFETY of all student drivers and equipment during testing Main Focus Area #3: Teamwork & Communication Maintain CDL, DOT Physical, and state Examiner certification Provide constructive feedback to Testing Manager and Instructors as required Maintain equipment and Range facilities and infrastructure Requirements Current CDL in state of employment CDL driving experience Training / instructional experience Managerial experience Oral and written communication Professional appearance to represent the campus and company. Requirements: Education and Certifications: Current CDL in state of employment Skills and Qualifications: • CDL driving experience • Training / instructional experience • Managerial experience • Oral and written communication • Professional appearance to represent the campus and company. Physical Requirements: 1. Maintain a current DOT Physical, CDL, and state Examiner certification. 2. Ability to sit for 1-2 hours to work on digital or hard-copy products.
    $40k-66k yearly est. 30d ago
  • Epic Medical Analyst

    Your It Recruiter

    Claim processor job in New York

    Your IT Recruiter is looking for an Epic Medical Analyst for our client. An Epic Medical Analyst, also referred to as an Epic Analyst or Epic Clinical Analyst, is an IT professional in healthcare specializing in the Epic Electronic Health Record (EHR) system. Their primary responsibilities revolve around implementing, optimizing, maintaining, and supporting Epic modules to enhance patient care and streamline workflows within healthcare organizations. Here's a breakdown of the key responsibilities, qualifications, and skills typically found in an Epic Medical Analyst job description: Key responsibilities and duties System configuration and maintenance Business Analysis and Workflow Improvement: Analyzing current workflows, identifying areas for improvement, and implementing Epic solutions to enhance efficiency. Collaborating with clinical and administrative teams to understand their needs and develop solutions within Epic. User Training and Support: Providing training to users on how to effectively utilize Epic, offering ongoing support, and addressing user inquiries. Documentation and Reporting: Creating and maintaining documentation, training materials, and user guides. Utilizing Epic's reporting tools to extract and analyze data for decision -making and quality improvement purposes. Collaboration and Communication: Working closely with clinical, IT, and administrative teams to ensure system requirements are met and to facilitate smooth implementation and ongoing support. Testing and Quality Assurance: Conducting system testing, quality assurance, and ensuring system updates and patches are properly implemented. Process Improvement: Participating in process improvement projects to enhance efficiency and accuracy. Requirements Required qualifications Education: Typically requires a Bachelor's degree in a related field such as Computer Science, Healthcare Information Technology, or Health Information Management. A Master's degree may be preferred. Experience: Minimum of one year of experience with the build and/or maintenance of Epic modules is often required. Some positions may prefer two or more years of relevant experience. Certification: Epic Certification in relevant modules (e.g., EpicCare Ambulatory, EpicCare Inpatient, Clinical Documentation) is usually a requirement or highly preferred, according to Medisys Health Network, Hospital for Special Surgery, and ZipRecruiter. Necessary skills Key skills for an Epic Medical Analyst include strong communication, organization, attention to detail, and the ability to multitask and work independently. Technical expertise in healthcare, IT and troubleshooting is essential. Analytical and problem -solving abilities are important, as is the capacity to collaborate with diverse teams. A solid understanding of healthcare operations, clinical workflows, and proficiency in Microsoft Office Suite are often required. Knowledge of HIPAA and other healthcare data privacy regulations is necessary. Staying current with industry trends and advancements in Epic applications is also valued. Overall, an Epic Medical Analyst is crucial for ensuring the Epic EHR system effectively supports a healthcare organization's operations, leading to improved patient care and efficiency. BenefitsContract Role
    $35k-55k yearly est. 5d ago
  • Billing/Claims Specialist

    P4P

    Claim processor job in New York, NY

    Job DescriptionLocation: Brooklyn, NY Salary: $52K-$80KThe Billing and Claims Specialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials.Key Responsibilities for Billing/Claims Specialist: Billing & Claims Processing Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance Review authorizations, service hours, and eligibility prior to billing Ensure accurate coding and claim data in accordance with payer guidelines Process electronic and paper claims as required by payers Claims Follow-Up & Reconciliation Monitor claim status and follow up on unpaid, denied, or underpaid claims Investigate and resolve billing discrepancies and denials Submit corrected or resubmitted claims as needed Post payments, adjustments, and denials accurately into billing systems Reconcile remittance advice (EOBs/ERAs) with billed claims Authorization & Compliance Track MLTC authorizations, service limits, and expiration dates Ensure billing aligns with approved care plans and service authorizations Maintain compliance with Medicaid, MLTC, and insurance regulations Stay current on payer rule changes and billing requirements Qualifications for Billing/Claims Specialist: Required Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting Hands-on experience with MLTC billing and insurance claims Strong knowledge of Medicaid and managed care billing processes Proficiency with home care billing software and clearinghouses Excellent attention to detail and organizational skills
    $52k-80k yearly 6d ago
  • Examiner

    CDL Schools

    Claim processor job in Menands, NY

    Full-time Description The Examiner at CDL Schools administers CDL Skills Exams (vehicle inspection, basic control skills, road test) in accordance with state requirements and maintains proper documentation. Main Focus Area #1: Compliance Maintain your certification as a state CDL Examiner, to include submitting to a background check Properly document all tests and communicate challenges with state Testing Manager Complete annual co-scores as required with state monitoring agencies. Main Focus Area #2: Testing Maintain current CDL and DOT Physical Administer CDL Skills Tests in accordance with state requirements and scoring standards Ensure the SAFETY of all student drivers and equipment during testing Main Focus Area #3: Teamwork & Communication Maintain CDL, DOT Physical, and state Examiner certification Provide constructive feedback to Testing Manager and Instructors as required Maintain equipment and Range facilities and infrastructure Requirements Current CDL in state of employment CDL driving experience Training / instructional experience Managerial experience Oral and written communication Professional appearance to represent the campus and company. Salary Description $20-$28 per hour plus incentive pay
    $20-28 hourly 60d+ ago
  • Transactional Risk Claims Specialist

    Howden Group Holdings Ltd.

    Claim processor job in New York, NY

    Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden. * Classification: Exempt/Full-time * Reports to: Head of Claims for Transactional Risk * Travel: 0-15% * Salary: $150,000.00-$215,000.00 Role overview DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team. The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice. This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time. Role responsibilities * Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion. * Assist with entering claim data into operational systems. * Assist with quality control and performance management, to ensure high-quality claim handling. * Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers. * Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices. * Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners. * Perform other duties as assigned. Key requirements * Bachelor's degree required and law degree preferred. * Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable. * Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions. * Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives. * Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint). * Ability to manage multiple competing priorities. * Ability to adapt to evolving regulatory and legal environments. * Complete assigned tasks correctly, on time and able to learn quickly. * Self-motivated and demonstrating attention to detail. * Be able to work independently for extended periods. * Excellent written and verbal communication skills as well as general business understanding. * Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment. * If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team. What do we offer in return? A career that you define. Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more. What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community. Our culture: people first Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world. The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key. Diversity and inclusion At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances. What do we offer in return? A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us: * Our successes have all come from someone brave enough to try something new * We support each other in the small everyday moments and the bigger challenges * We are determined to make a positive difference at work and beyond Reasonable adjustments We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*. If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require. * Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more. Permanent
    $43k-77k yearly est. Auto-Apply 39d ago
  • Complex Claims Specialist - Cyber, Technology, Media & Crime

    Hiscox

    Claim processor job in Hartford, CT

    Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture
    $44k-76k yearly est. Auto-Apply 9d ago
  • Complex Claims Examiner

    Nyt Usd

    Claim processor job in Day, NY

    About Us Since 1977 we have delivered first class solutions to insurers worldwide, by combining global reach with local decision making. We have built customer & broker relationships on years of trust, experience and execution. Through our people, our products and our partnerships, we deliver the capacity and expertise necessary to contribute to the sustainable growth of prosperous communities worldwide. To do so, our colleagues work with: Integrity Work honestly, to enhance TransRe's reputation Respect Value all colleagues. Collaborate actively. Performance We reward excellence. Be accountable, manage risk and deliver TransRe's strengths Entrepreneurship Seize opportunities. Innovate for and with customers. Customer Focus Anticipate their priorities. Exceed their expectations. We have the following job opportunity in our New York City office: Description We seek an experienced claims professional to join our growing FAIRCO team in our New York City office. FAIRCO is a subsidiary of TransRe Holdings, a Berkshire Hathaway company. As a member of FAIRCO, the Complex Claims Examiner will be responsible for adjusting Professional & Management Liability claims, with opportunities for experiences with other FAIRCO programs. Responsibilities will include but not be limited to: Managing and adjusting primary and excess Professional & Management Liability claims, including private and public company, Directors and Officers, lawyers liability, accountants liability, financial institutions, cyber, employment practices and miscellaneous professional liability. Proactively handling claims throughout the entire claim lifecycle from inception to resolution. Analyzing policy coverage and drafting coverage analyses based on contract terms and claim details. Evaluating liability and damages to determine the level of exposure to the insured and the policy. Directing and closely monitoring assignments to defense counsel and experts in accordance with relevant guidelines. Collaborating with underwriters, brokers, program partners, and insureds to ensure seamless claims resolution. Traveling to and attending claims mediations, as required. Developing and implementing claims handling strategies to mitigate risk and reduce claim expenses. Requirements The ideal candidate will possess the following knowledge, skills and abilities: Extensive experience litigating or handling issues pertaining to complex Professional & Management Liability issues, with a focus on Directors and Officers coverage. Experience leading mediations for Professional & Management Liability claims. Experience evaluating coverage under various types of policies, drafting coverage correspondence, and participating in claims investigations. Track record of effectively managing defense counsel and legal spend, assessing liability and financial exposure, and effectively negotiating cost effective, good faith claims resolutions. Juris Doctorate preferred. Willingness to travel up to 25% of the time for mediations, industry conferences, and client meetings. Possession of, or willingness to obtain, a New York and other state adjuster's licenses. Work Schedule TransRe is supportive of an agile work schedule, which may differ based on individual roles, your local office's practices and preferences, marketplace trends, and TransRe's business objectives. This position is eligible for a hybrid work schedule with 3 days in the office per week, and 2 days remote. Compensation In addition to base salary, for this position, TransRe offers a comprehensive benefits package, paid time off, and incentive pay opportunity. The anticipated annual base salary range in New York for this position, exclusive of benefits, paid time off, and incentive pay opportunity is $140,000 - $180,000. This range is an estimate, and the actual base salary offered for this position will be determined based on certain factors, including the applicant's specific skill set and level of experience. We are an Equal Opportunity Employer (EOE) and we support diversity in the workforce.
    $30k-56k yearly est. Auto-Apply 60d+ ago
  • Litigated Claims Specialist

    DWP, IWP, and AWP Careers

    Claim processor job in Andover, MA

    Working as part of the Claims Department, the Litigated Claims Specialist lends expertise in the laws, regulations, and jurisdictional statutes to identify or resolve disputed claims, assuring effective reimbursement. What You'll Do Investigate/rectify partial payments from claims in litigation Secure payment on outstanding invoices Investigate claim that are in litigation Assess current and ongoing risk of continued medications service in relation to ongoing litigation Research and act upon information obtained Interact and communicate daily with other departments Communicate with external sources such as attorneys and adjusters Obtain medical documentation to facilitate/warrant collections Analyze information and data for resolution Participate and develop special processes/procedures to better the Litigated Claims Team Special projects as designated by manager What You'll Need to Succeed 2+ years Workers Compensation knowledge Bachelor's Degree or equivalent related experience Familiar with medical terminology Knowledge of databases and MS Office (Excel & Word) Knowledge of IWP reimbursement process and procedures Make A Difference With IWP Injured Workers Pharmacy (IWP) is proud to be THE Patient Advocate Pharmacy, helping injured workers around the country access their prescription medications with ease. As a specialized workers' compensation home delivery pharmacy, we collaborate with the legal, medical, and insurance communities to help injured workers return to a productive life. At IWP we believe in our service, but it's the people who make it a great place to work. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you'd like to be part of, we'd love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development. IWP is an Equal Opportunity Employer. IWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law. All employment decisions are made on the basis of qualifications, merit, and business need. IWP is committed to providing reasonable accommodations for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at humanresources@IWPharmacy.com We will make a determination on your request for reasonable accommodation on a case-by-case basis. We are dedicated to attracting and retaining top talent with competitive and fair compensation. The salary range for this role is $23/hr - $25/hr.
    $23-25 hourly 2d ago
  • Healthcare Malpractice Liability Claims Specialist

    Axis Capital Holdings 4.0company rating

    Claim processor job in Day, NY

    This is your opportunity to join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry. At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process. About the Team AXIS is hiring a Claims Specialist, Health Care Claims, for its North America Claim Team. This role involves managing primary and excess healthcare liability claims for AXIS U.S. policies. How does this role contribute to our collective success? You will handle highly complex healthcare liability claims by verifying coverage, conducting investigations, developing resolutions, and authorizing disbursements within authority limits. Ensure consistent communication with stakeholders, brokers, and insureds to uphold service excellence. Process, analyze, investigate, evaluate, and resolve claims for accurate settlements. Collaborate with internal teams and external stakeholders to deliver exceptional service and support claims department success. What Will You Do In This Role? Assessing claims within a specialized area to determine coverage, liability, and settlement value. Collaborating with legal and investigative teams to resolve complex or contentious claims. Leading initiatives to enhance claims processing efficiency and accuracy within the team. Providing expert opinions on claims handling best practices during cross-functional meetings. Managing costs in collaboration with the Litigation Management and Vendor Management teams. Participating in professional associations to stay abreast of changes in claims management. Communicating with key stakeholders both internal and external to the company. Serving as a mentor, fostering skill development and career progression. About You We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals. What We're Looking For Be recognized as a subject matter expert in claims within their area of specialization. Exhibit the ability to network effectively and leverage professional associations for knowledge enhancement. Demonstrate the capability to lead process enhancement initiatives within a claims environment. Possess the skills to provide expert opinions and insights during cross-functional discussions. Be adept at creating and directing the development of training materials relevant to claims processing. Show a commitment to continuous professional development in the field of claims management. Have the ability to critically review and update claims procedures to maintain regulatory compliance. Be capable of mentoring peers and fostering their professional growth within the claims discipline. Role Factors This role requires you to be in the office 3 days per week and adhere to AXIS licensing requirements. What We Offer Your salary offer will be based on an assessment of a variety of factors including your specific experience and work location. In addition, you will be offered competitive target incentive compensation, with awards based on overall corporate and individual performance. On top of this, you will be eligible for a comprehensive and competitive benefits package which includes medical plans for you and your family, health and wellness programs, retirement plans, tuition reimbursement, paid vacation, and much more. Where this role is based in the United States of America, this role is exempt for FLSA purposes. About Axis This is your opportunity to join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry. At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process. AXIS Persona AXIS Capital seeks professionals who thrive in a dynamic, high-performing environment grounded in humility and mutual respect. We employ those who exemplify our core values of People, Excellence, Decisiveness, and Stronger Together. We are a team characterized by integrity and self-discipline, striving for continuous improvement and driven to achieve ambitious results. Our focus is on hiring, developing, retaining, and rewarding individuals who excel in: Purposeful Action: Delivering top-tier work with a data-driven approach and operating at AXIS speed. Collaborative Decision-Making: Valuing input from all relevant groups and being open to debate. Able to leave their ego at the door and be committed to achieving results through teamwork, fully supporting decisions once made. Measuring Outcomes: Consistently evaluating performance against established expectations. The AXIS employee will cultivate a collaborative workplace atmosphere, fostering trust within the team. We believe in respectful challenges, presuming best intent, and building meaningful relationships with colleagues, customers, and the communities we serve. Joining our team means becoming part of a workplace where every individual's contributions are valued, and excellence is pursued with purpose and passion. Together, we elevate our standards, achieve ambitious results, and make a lasting impact on each other and those we serve. For this position, we currently expect to offer a base salary in the range of $75,000.00 to $120,000.00 (NY). Your salary offer will be based on an assessment of a variety of factors including your specific experience and work location. In addition, you will be offered competitive target incentive compensation, with awards based on overall corporate and individual performance. On top of this, you will be eligible for a comprehensive and competitive benefits package which includes medical plans for you and your family, health and wellness programs, retirement plans, tuition reimbursement, paid vacation, and much more. Where this role is based in the United States of America, this role is Exempt for FLSA purposes.
    $75k-120k yearly Auto-Apply 4d ago

Learn more about claim processor jobs

How much does a claim processor earn in Albany, NY?

The average claim processor in Albany, NY earns between $23,000 and $78,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Albany, NY

$43,000

What are the biggest employers of Claim Processors in Albany, NY?

The biggest employers of Claim Processors in Albany, NY are:
  1. Easy Recruiter
  2. Sourcedge Solutions
  3. Welbehealth
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