Claims Examiner
Claim processor job in Connecticut
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
Auto-ApplyClaims Examiner-Lost Time
Claim processor job in New Haven, CT
**Ready, set, go!** Put your career in motion with a great, new opportunity. Join the Kelly Professional & Industrial team as an **Claims Examiner-Lost Time** with one of the best industries in the world for Insurance and Reinsurance. **Why you should apply to be** **an** **Claims Examiner-Lost Time** **:**
· Pay Rate: $41.30 per hour
· Employment Type: Temp to hire
· Location: New Haven CT 06511
· Schedule: 1st Shift (Mon-Fri) 8:30am-5:00pm EST
· Great Advancement Opportunities
· Overtime available
· Weekly pay
**What a typical day as** **an** **Claims Examiner-Lost Time** **might look like:**
Handles all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
Reviews claim and policy information to provide background for investigation.
Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.
Evaluates the facts gathered through the investigation to determine compensability of the claim.
Informs insureds, claimants and attorneys of claim denials when applicable.
Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to Team
Leader throughout the life of the claim.
Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
Works with attorneys to manage hearings and litigation
Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.
Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews.
Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations.
Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
Works with in-house Technical Assistants, Special Investigators, Nurse
Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.
**This job might be an outstanding fit if you:**
Experience working in a customer focused, fast-paced, fluid environment
Experience utilizing strong communication and telephonic skills
Prior experience requiring a high level of organization, follow-up and accountability
Prior workers' compensation claim handling experience is a plus but not required
Familiarity with claim handling (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, or general liability) is a plus but not required
Prior insurance, legal or corporate business experience is a plus but not required
AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required
Proficiency with Microsoft Office Products
Knowledge of medical terminology is a plus but not required
Knowledge of bill processing is a plus but not required
Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island and Vermont, are necessary; however, they are not required at the time of posting for the position. If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure
**What happens next:**
Once you apply, you'll proceed to the next steps if your skills and experience look like a good fit. But don't worry-even if this position doesn't work out, you're still in our network. That means all our recruiters at Kelly will have access to your profile, expanding your opportunities even more!
Helping you discover what's next in your career is what we're all about, so let's get to work. Apply to be an **Claims Examiner-Lost Time** today!
**\#P3**
**\#CB**
As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here (********************************************************************* for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.
Get a complete career fit with Kelly .
You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.
About Kelly
Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life-just ask the 300,000 people we employ each year.
Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.
Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly's Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.
Claims Examiner
Claim processor job in Hartford, CT
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence.
Responsibilities:
* Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level
* Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution
* Review and analyze supporting damage documentation
* Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions
* Establish appropriate loss and expense reserves with documented rationale
* Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines
Experience & Qualifications
* Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word
* Knowledge of ImageRight preferred
* Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
* Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions
* Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines
* Ability to work well independently and in a team environment
* Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date.
Education
* Bachelor's degree preferred
* 3-5 years' experience handling the process of commercial insurance claims
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$71,900 - $97,110/year
* Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
* Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
14400 Arch Insurance Group Inc.
Auto-ApplyClaims Specialist - Professional Liability
Claim processor job in Hartford, CT
Claims Specialist, Professional Liability (also open to Senior Claims Specialist level) Hartford, CT Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle the most complex claims seamlessly. How do you make a good thing better? You focus on excellence and creating a culture of continuous improvement.
You create an environment that fosters collaboration, customer service and colleague development.
As a Claims Specialist (also open to Senior Claims Specialist level) in the Hartford Professional claims unit, you will play a critical role by managing and resolving claims under various types of primary and excess professional liability policies, which could include public company directors & officers ("D&O") liability policies; financial institution D&O and errors & omissions ("E&O") policies; insurance company and insurance agents & brokers E&O policies; fiduciary liability policies; and employment practices liability policies.
You will work closely with your manager to bring claims to resolution.
You will interact and collaborate with regional practice leaders, our professional underwriters, brokers and clients on assigned accounts, taking ownership of critical issues relating to claims management.
Our professional liability claims handlers are tasked with resolving and settling claims proactively in order to achieve exceptional outcomes.
What you'll be DOING What will your essential responsibilities include? Proactively managing assigned professional liability claims across multiple lines of business, including initial analysis, drafting coverage letter, preparing a resolution strategy, and ensuring ongoing communication with stakeholders and claims management to achieve the best outcome for the client and AXA XL.
Using robust technical skills, handle complex and difficult claims within authority level and specialization.
Partnering with internal and external counsel in setting and pursuing effective and cost-efficient litigation strategies for claims in litigation, consistent with AXA XL litigation management best practices.
Coordinating and managing communications with internal colleagues and key external stakeholders (e.
g.
, clients, brokers, reinsurers, vendors, etc.
), ensuring we are providing the highest level of customer service.
Ensuring all documentation is present in the claim file and ensuring that Claims Handler Guidelines and protocols are followed.
Managing expenses through thoughtful expense management and claims best practices.
Assisting our underwriters with policy review and participating in external marketing and business development activities.
Sharing lessons leaned and other identified trends to improve risk assessment and the underwriting process.
Participating in the quality review procees and seeking to identify new and improved processes.
Embracing short and long-term improvement initiatives.
Producing internal reporting in support of best practices and reserving guidelines.
Following the AXA XL Claim Alert process.
Identifying, monitoring and reporting on emerging liability and coverage trends.
Coaching less experienced colleagues and being a role model in best practices.
You will report to Claims Manager, Hartford Professional.
What you will BRING We're looking for someone who has these abilities and skills: Required Skills and Abilities: Education: Bachelor's degree required; Juris Doctor (JD) required.
Experience: Professional liability claims-handling experience.
Working knowledge of applicable regulations.
Experience managing, negotiating and resolving high exposure and complex claims.
Licensing: Insurance adjuster licenses for all states requiring licenses or willingness to immediately obtain such licenses upon starting.
Proactive and Results Oriented File Handling: Ability to proactively manage assigned claims across multiple lines of the professional liability business.
Approach tasks proactively and anticipate needs.
Think quickly and prioritize multiple workstreams, while maintaining quality.
Analytical and Technical Skills: Robust analytical and technical skills to handle complex and difficult claims.
Sound judgment skills.
Collaboration: Ability to collaborate with claims management on large and complex losses.
Ability to develop and maintain productive working relationships with all colleagues, including insureds, brokers, claim handlers, underwriters and legal counsel.
Willingess to seek input from others as needed to achieve the best result possible for the client and AXA XL.
Communication: Excellent verbal and written communication, presentation and influencing skills.
Ability to communicate effectively with internal and external stakeholders to make sure we provide the highest level of customer service.
Ethics: Handle responsibilities with integrity and to the highest standards of professionalism.
Continuous Improvement Focused: Willing to ask questions and explore new ideas.
Eager to learn and ability to focus on continuously improving technical skills and AXA XL claims capabilities.
Client-Service Oriented: Focus on value at all points in the claims experience, delivering on our promise to our clients.
Who WE are AXA XL, the P&C and specialty risk division of AXA, is known for solving complex risks.
For mid-sized companies, multinationals and even some inspirational individuals we don't just provide re/insurance, we reinvent it.
How? By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business − property, casualty, professional, financial lines and specialty.
With an innovative and flexible approach to risk solutions, we partner with those who move the world forward.
Learn more at axaxl.
com What we OFFER Inclusion AXA XL is committed to equal employment opportunity and will consider applicants regardless of gender, sexual orientation, age, ethnicity and origins, marital status, religion, disability, or any other protected characteristic.
At AXA XL, we know that an inclusive culture and enables business growth and is critical to our success.
That's why we have made a strategic commitment to attract, develop, advance and retain the most inclusive workforce possible, and create a culture where everyone can bring their full selves to work and reach their highest potential.
It's about helping one another - and our business - to move forward and succeed.
Five Business Resource Groups focused on gender, LGBTQ+, ethnicity and origins, disability and inclusion with 20 Chapters around the globe.
Robust support for Flexible Working Arrangements Enhanced family-friendly leave benefits Named to the Diversity Best Practices Index Signatory to the UK Women in Finance Charter Learn more at Inclusion & Diversity at AXA XL | AXA XL.
AXA XL is an Equal Opportunity Employer.
Total Rewards AXA XL's Reward program is designed to take care of what matters most to you, covering the full picture of your health, wellbeing, lifestyle and financial security.
It provides competitive compensation and personalized, inclusive benefits that evolve as you do.
We're committed to rewarding your contribution for the long term, so you can be your best self today and look forward to the future with confidence.
Sustainability At AXA XL, Sustainability is integral to our business strategy.
In an ever-changing world, AXA XL protects what matters most for our clients and communities.
We know that sustainability is at the root of a more resilient future.
Our 2023-26 Sustainability strategy, called "Roots of resilience", focuses on protecting natural ecosystems, addressing climate change, and embedding sustainable practices across our operations.
Our Pillars: Valuing nature: How we impact nature affects how nature impacts us.
Resilient ecosystems - the foundation of a sustainable planet and society - are essential to our future.
We're committed to protecting and restoring nature - from mangrove forests to the bees in our backyard - by increasing biodiversity awareness and inspiring clients and colleagues to put nature at the heart of their plans.
Addressing climate change: The effects of a changing climate are far-reaching and significant.
Unpredictable weather, increasing temperatures, and rising sea levels cause both social inequalities and environmental disruption.
We're building a net zero strategy, developing insurance products and services, and mobilizing to advance thought leadership and investment in societal-led solutions.
Integrating ESG: All companies have a role to play in building a more resilient future.
Incorporating ESG considerations into our internal processes and practices builds resilience from the roots of our business.
We're training our colleagues, engaging our external partners, and evolving our sustainability governance and reporting.
AXA Hearts in Action: We have established volunteering and charitable giving programs to help colleagues support causes that matter most to them, known as AXA XL's "Hearts in Action" programs.
These include our Matching Gifts program, Volunteering Leave, and our annual volunteering day - the Global Day of Giving.
For more information, please see Sustainability at AXA XL.
The U.
S.
base salary range for the Claims specialist position is 92,500-138,500 USD and for the Senior Claims Specialist is: 115,500-173,500 USD.
Actual pay will be determined based upon the individual's skills, experience and location.
We strive for market alignment and internal equity with our colleagues' pay.
At AXA XL, we know how important physical, mental, and financial health are to our employees, which is why we are proud to offer benefits such as a competitive retirement savings plan, health and wellness programs, and many other benefits.
We also believe in fostering our colleagues' development and offer a wide range of learning opportunities for colleagues to hone their professional skills and to position themselves for the next step of their careers.
For more details about AXA XL's benefits offerings, please visit US Benefits at a Glance 2025.
Complex Claims Specialist, Managed Care, E&O, D&O
Claim processor job in Weatogue, CT
Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business.
*This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change.
Responsibilities
Analyzes, investigates and evaluates the loss to determine coverage and claim disposition.
Utilizes proprietary claims management system to document claims and to diary future events or follow up.
Issue detailed coverage position letters for all new claims within prescribed time frames.
Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level.
Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting.
Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment.
Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority.
Participates in the claims audit process.
Provides claims marketing services by meeting with brokers and insureds.
As required, maintains insurance adjuster licenses
Qualifications
Bachelors' and/or advanced degree
7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers)
Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge
Functional knowledge of law and insurance regulations in various jurisdictions
Demonstrated advanced verbal and written communications skills
Demonstrated advanced analytical, decision making and negotiation skills
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
California
Los Angeles Incorporated
Los Angeles Unincorporated
Philadelphia
San Francisco
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Auto-ApplyComplex Claims Specialist-MPL
Claim processor job in Connecticut
Job Type: Permanent Build a brilliant future with Hiscox Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlement of Miscellaneous Professional Liability insurance claims. May be responsible for single or multi-country claims and will be responsible for all aspects of the claims, including liaise with external and internal business partners (e.g., outside experts and/or or legal counsel; underwriting) as required.
Bring your Passion and Enthusiasm to our Team! We are a fun, innovative and growing Claims team where you'll get the opportunity to learn multiple insurance products and interact with business leaders across the organization.
Please note that this position is hybrid and requires two (2) days in office weekly. Position can be based in the following locations:
* Manhattan, NY
* West Hartford, CT
* Atlanta, GA
* Chicago, IL
* Boston, MA
The Role:
The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also:
* Adjusts and resolves complex to severe claims that includes all phases of litigation
* With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters
* Reviews and analyses claim documentation and legal filings
* Drives litigation best practices to lead defense strategy on litigated files
* Mentors Claim Examiners
* Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
* Identifies emerging exposures and claims trends
* Identifies suspected fraudulent claims and tracks with special investigations unit
* Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
* Develops content and conducts training for claims team and underwriters as requested
The Team:
The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling.
Requirements:
* 8+ years of claims handling experience or 7-8 years litigation experience. (A JD from an ABA accredited law school may be considered as a supplement to claims handling 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
* Experience in mentoring and training other claims examiners
* Excellent verbal and written communication skills
* Advanced analytical skills
* B.A./B.S degree from an accredited College or University preferred
Additional Factors Considered
Ability to act a subject matter expert within team Demonstrated ability to work with minimal oversight Experience attending and leading mediations, arbitrations and trials Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars.
What Hiscox USA offers
* 401(k) with competitive company matching
* Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
* Company paid group term life, short- term disability and long-term disability coverage
* 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 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
* 2023 Gold level recipient of Cigna's Healthy Workforce Designation 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.
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.
Diversity and flexible working at Hiscox
At Hiscox we care about our people. We hire the best people for the job and we're committed to diversity and creating a truly inclusive culture, which we believe drives success. We also understand that working life doesn't always have to be 'nine to five' and we support flexible working wherever we can. No promises, but please chat to our resourcing team about the flexibility we could offer for this role.
You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance)
Salary range $125,000 - $155,000 (Boston, Manhattan, West Hartford)
Salary range $120,000-$130,000 (Chicago, Atlanta)
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-AJ1
Work with amazing people and be part of a unique culture
Auto-ApplySr. Claims Analyst, Environmental Casualty
Claim processor job in Farmington, CT
Sr. Claims Analyst, Environmental Casualty - (25000048) Description Location: New York, NY, New Jersey, Farmington, CT, or other Allied World office locations. Job Summary:Investigate, evaluate, and resolve claims asserted against the Company's environmental policies.
Engage in collaborative projects in support of other areas of the company, including underwriting, finance and accounting, actuarial, operations, and technology.
Provide superior service to all customers, whether internal or external.
Job Responsibilities:· Efficiently manage a vigorous load of claims involving a broad spectrum of accounts and coverages.
Promptly analyze coverage, draft accurate and timely coverage positions, and manage litigation by effectively interacting with insureds, brokers, defense counsel, underwriters and other parties as required.
Establish timely and appropriate reserves and regularly report claim developments and trends to claims and underwriting management.
Represent Company in the resolution of claims and participate in legal proceedings, including mediations.
· Work with other areas of the Company including underwriting, finance and accounting, actuarial, operations and technology on projects as requested.
Prepare claim summaries and other reports as necessary for management.
Prepare Executive Claim reports and present on a quarterly basis to senior executives.
· Meet with existing or prospective clients and brokers.
Attend relevant industry conferences/meetings.
Qualifications CompensationThe below annualized base pay range is a broad range based on analysis of similar positions in the market.
The actual base pay for the position may be above or below he listed range and determined by a number of considerations, including but now limited to complexity, location, and scope of the role, along with experience, skills, education, training, and other conditions of employment.
Base salary represents one compensation of Allied World comprehensive total reward package, which may also include annual incentive compensation rewards.
The salary range is flexible and will be determined according to the candidate's experience.
$105,000 - $113,000Qualifications:· Minimum of 2 years' experience handling claims.
· Four-year college degree is required.
Knowledge of claims, legal and coverage issues in all U.
S.
jurisdictions.
Excellent negotiation and communication skills.
Strong technical skills and writing experience.
Proficient with Microsoft Office products, internet research.
Ability to accurately and timely analyze coverage, draft coverage position letters and interact and collaborate with counsel regarding litigation and coverage strategies, negotiate and resolve claims and otherwise act within the scope of delegated authority.
Compliance with multi-state adjuster licensing requirements.
Some travel required.
About FairfaxFairfax is a holding company which, through its subsidiaries, is engaged in property and casualty insurance and reinsurance and investment management.
About Allied WorldAllied World Assurance Company Holdings, Ltd, through its subsidiaries, is a global provider of insurance and reinsurance solutions.
We operate under the brand Allied World and have supported clients, cedents and trading partners with thoughtful service and meaningful coverages since 2001.
We are a subsidiary of Fairfax Financial Holdings, Limited and benefit from a strong capital base and a worldwide network of affiliated entities that allow us to think and respond in non-traditional ways.
Our generous benefits package includes Health, Dental and Disability Insurance, a company match 401k plan, and Group Term Life Insurance.
Allied World is an Equal Opportunity Employer.
All qualified applicants will be considered for employment without consideration of any disability, veteran status or any other characteristic protected by law.
To learn more, visit awac.
com, or follow us on Facebook at facebook.
com/alliedworld and LinkedIn at linkedin.
com/company/allied-world.
Primary Location: US-NY-New YorkOther Locations: US-CT-Farmington, US-NJ-IselinWork Locations: New York 199 Water Street New York 10038Job: ClaimsEmployee Status:RegularJob Type:StandardJob Posting: Oct 31, 2025, 1:02:59 PMMaximum Salary113,000.
00Pay BasisYearly
Auto-ApplyStop Loss & Health Claim Analyst
Claim processor job in Hartford, CT
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. 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. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
The Opportunity:
This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim.
The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources.
How you will contribute:
• Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
• The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions
• Maintain claim block and meet departmental production and quality metrics
• An awareness of industry claim practices
• Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records
• Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc.
• Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process
• Establish cooperative and productive relationships with professional resources
What you will bring with you:
• Bachelor's degree preferred
• A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing
• Demonstrated ability to work as part of a cohesive team
• Strong written and verbal communication skills
• Knowledge of Stop Loss Claims and Stop Loss industry preferred
• Demonstrated success in negotiation, persuasion, and solutions-based underwriting
• Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism
• Overall knowledge of health care industry
• Proficiency using the Microsoft Office suite of products
• Ability to travel
Salary Range: $54,900 - $82,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
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.
Job Category:
Claims - Life & Disability
Posting End Date:
30/10/2025
Auto-ApplyStop Loss & Health Claim Analyst
Claim processor job in Hartford, CT
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. 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. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
The Opportunity:
This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim.
The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources.
How you will contribute:
• Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
• The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions
• Maintain claim block and meet departmental production and quality metrics
• An awareness of industry claim practices
• Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records
• Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc.
• Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process
• Establish cooperative and productive relationships with professional resources
What you will bring with you:
• Bachelor's degree preferred
• A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing
• Demonstrated ability to work as part of a cohesive team
• Strong written and verbal communication skills
• Knowledge of Stop Loss Claims and Stop Loss industry preferred
• Demonstrated success in negotiation, persuasion, and solutions-based underwriting
• Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism
• Overall knowledge of health care industry
• Proficiency using the Microsoft Office suite of products
• Ability to travel
Salary Range: $54,900 - $82,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
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.
Job Category:
Claims - Life & Disability
Posting End Date:
30/01/2026
Auto-ApplyClaims Analyst
Claim processor job in Glastonbury, CT
Travel Insured International (TII), a Crum & Forster company, is hiring for a Claims Analyst.
Travel Insured International is a leading travel insurance provider with more than 25 years in business. As a key component of our Small Business Unit, within the Accident & Health division, TII provides travel protection plans to help each individual travel confidently. Travel Insured International is proud to offer products to consumers and to agency partners of all sizes. We're committed to providing dependable coverage, great value, and end-to-end satisfaction for all customers.
This is an entry to mid-level position designed to allow the appropriate candidate to grow and develop skills and expertise and transition to more complex claim handling responsibilities. Works under general supervision and reports to a Team Leader and/or Manager.
Achieve superior customer service and claim handling at the most reasonable cost/efficiency by completing essential claim adjudication tasks including denying, settling, or requesting payments for claims based on coverage and proof of loss.
Job Description
Corresponds through verbal/written communication with policyholders, claimants, travel coordinators, etc. to gather important information to support claim decision.
Serve as a customer advocate in all interactions to provide an outstanding customer experience.
Review, assess, and process claims with adhering to established SLAs
Prompt responses to all status calls (next business day standard)
Maintain SLAs on DOI, Attorney Demand and BBB complaints
Deliver complete, timely, and accurate work
Thoroughness of file documentation of spreadsheets and diary
Minimum number of claim appeals overturned due to analyst error
Manage work queue independently
Take ownership of claim decisions and work queue
Communicate effectively both written and verbal
Recognize fraud and subrogation opportunities and refer to appropriate expert
Consistently provide high-level customer service
Adhere to documented procedures
Demonstrate reliability (attendance, punctuality, time management)
Show respect for co-workers and external contacts (customers, agents, third party providers, etc.)
Show commitment to supporting team goals (e.g. eliminating backlogs, adherence to Work Force Management)
Participate in Operations and Companywide initiatives (Focus Groups, Pilots, System Enhancements)
Be a positive influence in the unit and exhibit professionalism
Leadership (willingness to put forth ideas to improve unit performance)
Willingness to accept constructive criticism (coachable)
Support of Team TII or other community initiatives
Continuous acquisition, development, and refinement of your skills as a claim professional
Embrace and practice Pete's Principles
What YOU will bring to C&F:
Solid knowledge of principles and processes for claim examination, evaluation, and disposition
Strong problem solving and decision-making skills
Ability to adjust readily to multiple demands and constituencies, shifting priorities, and rapid change
Active listening skills
Ability to communicate in a clear, concise manner appropriate to the audience via phone, email, and in writing
Demonstrated ability to work independently
Requirements:
Bachelor's degree or equivalent work experience preferred, high school diploma/GED and 3+ years of experience required
Strong computer literacy with demonstrated keyboard skills, solid knowledge of technology used for claims administration, and familiarity with Microsoft office software and Cloud base systems
Prior customer service experience, within a claim environment a plus
What C&F will bring to you
What C&F will bring to YOU:
Competitive compensation package
Generous 401K employer match
Employee Stock Purchase plan with employer matching
Generous Paid Time Off
Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness including your physical, mental and financial wellbeing
A core C&F tenant is owning your career development so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry related certifications and professional training to keep you progressing on your chosen path
A dynamic, ambitious, fun and exciting work environment
We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. If you require a special accommodation, please let us know.
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $32,700 to a maximum of $61,500. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
#LI-MU1
#LI-REMOTE
Auto-ApplyClaims Specialist - Massachusetts
Claim processor job in East Hartford, CT
Job Description
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
This is a remote role.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
Ability to learn rapidly to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to meet or exceed performance competencies
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year of industry experience and claims management preferred
State Certification as an Experienced Examiner
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $51,807 - $83,551
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL
CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
General Liability Claim Representative
Claim processor job in Hartford, CT
Claims Representative - CH09CNAssociate Claim Representative - CH10DN We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future.
As a General Liability Associate Claims Representative for all business lines, you're at the front lines for our customer. Your primary role is to investigate and manage claim files to help individuals and businesses prevail after a claim. The Hartford will provide you with a robust training and onboarding program, as well as ongoing coaching and development to ensure your success.
Start Date: February 16, 2026
Hours: 8am-5pm, Core Business hours to support either our Eastern or Western region, limited flexibility.
Virtual Training: 8 weeks, core business hours, your local time
This role will have a Hybrid work arrangement, with the expectation of working in an office location : (Hartford, CT / San Antonio, TX / Aurora (Naperville) IL/ Lake Mary, FL/ Scottsdale, AZ ) 3 days a week (Tuesday through Thursday).
Responsibilities:
+ Utilize active listening and critical thinking skills to quickly analyze customer needs
+ Leverage knowledge and resources to provide the appropriate solutions to requests
+ Take ownership to ensure that we go above and beyond in providing customer service
+ Utilize every touch point as an opportunity to build value and The Hartford brand
+ Commit to learning and developing
+ Develop an in depth understanding of Hartford products and business lines
+ Act as a liaison with other departments to resolve problems
+ Secure essential facts about losses
+ Negotiate settlements
+ Interpret, understand and explain coverage to policyholders
+ Efficiently update and move files to closure
+ Manage pending claims to meet company quality criteria
+ Ensure payments are processed timely as needed or input payments within authority
+ Special assignments or projects as assigned
+ May be required to assist in catastrophe situations
+ Develop proficiency and capabilities expected during new hire ramp-up period
+ Must demonstrate strong customer service focus
+ Ability to operate, lead and coach within The Hartford Way management system
Qualifications:
+ High School Diploma required; college degree preferred
+ Minimum of 1 year of related customer service experience or applicable insurance experience
+ Excellent oral, written and interpersonal communication
+ Demonstrated capacity to multi-task in a structured work environment
+ Ability to utilize multiple systems to handle/process claims
+ Problem solving and critical thinking skills are a must
+ Strong attention to detail
Additional Information:
+ As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance Claims in the states supported by your office. Continued employment with The Hartford is contingent upon the successful passage of the Licensing exam(s) within 30 business days from the completion of the licensing training.
Compensation
The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford's total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:
$45,280 - $79,320
The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience.
Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age
About Us (************************************* | Our Culture (******************************************************* | What It's Like to Work Here (************************************************** | Perks & Benefits (*********************************************
Every day, a day to do right.
Showing up for people isn't just what we do. It's who we are - and have been for more than 200 years. We're devoted to finding innovative ways to serve our customers, communities and employees-continually asking ourselves what more we can do.
Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?
That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.
And while how we contribute looks different for each of us, it's these values that drive all of us to do more and to do better every day.
About Us (*************************************
Our Culture
What It's Like to Work Here (**************************************************
Perks & Benefits
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Accessibility Statement Producer Compensation (**************************************************
EEO
Privacy Policy (**************************************************
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Your California Privacy Choices (******************************************************
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Hartford India Prospective Personnel Privacy Notice
Claims Specialist
Claim processor job in Southington, CT
The GT Self Determination Claims Specialist maintains a core understanding of the company and of Operations. The GT Self Determination Claims Specialist is expected to follow departmental procedures and adhere to GT and agency guidelines to ensure work is completed accurately and efficiently. The GT Self Determination Claims Specialist maintains knowledge, skills, and abilities that contribute to various accounting/administrative tasks involved in preparing billing data for agencies in which GT Independence holds a contract. All GT Self Determination Claims Specialists must maintain a core understanding of the company and of Operations.
RESPONSIBILITIES AND DUTIES
· Preparation of billing data to be used in the billing of payers
· Responsible for complying with contractual provisions with each agency regarding the submission of billing and encounter data, including the related monthly reports
· Submit invoices to agencies
· Applies payments
· Collects on unpaid claims
· Prepares advance reconciliations and applies payments to the general ledger
· Enters information into computer databases for effective record keeping
· Collaborates with other staff members to optimize delivery of services
· Ensures all compliance standards are met for audit purposes
· Maintains confidentiality of records relating to clients
· Identifies opportunities to improve our processes
· Upholds company values and mission
· Other duties as assigned
EDUCATION
High School Diploma or GED required
Associate degree preferred
EXPERIENCE AND QUALIFICATIONS
· 2 years of experience relevant to the work performed
· Experience with Microsoft Office products is necessary, specifically Microsoft Excel
· Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, designing forms, and other office procedures and terminology
· Excellent written and oral communication skills
· Ability to plan and organize daily work to meet strict deadlines
· Strong attention to detail
· Able to work with numbers and apply basic math skills to daily tasks
· Strong ability to participate on a highly effective team
WORK ENVIRONMENT
Work is performed in a typical office setting or from a home office.
Workers' Compensation Claim Representative
Claim processor job in New Haven, CT
Chubb is currently seeking a Workers' Compensation Claim Representative for our Northeast, New York, and New Jersey Region. The successful applicant will be handling claims from Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, and New Jersey. The position will report to, and reside in, our New Haven, Connecticut, office.
Duties & Responsibilities:
Handles all aspects of workers' compensation medical only claims from set-up to case closure, ensuring strong customer relations are maintained throughout the process.
Reviews claim and policy information to provide background for the investigation.
Conducts three-part ongoing investigations, obtaining facts and taking statements as necessary, with the insured, claimant, and medical providers.
Evaluates the facts gathered through the investigation to determine the compensability of the medical treatment.
Informs insureds and claimants of claim denials when applicable.
Prepares reports on investigations, settlements, denials of claims, evaluations of involved parties, etc.
Timely administration of statutory medical only benefits throughout the life of the claim.
Sets reserves within authority limits for medical and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
Controls and directs vendors, nurse case managers, and telephonic case managers on medical management.
Complies with customer service requests, including Special Claims Handling procedures and file status notes.
Submits workers' compensation forms and electronic data to states to ensure compliance with statutory regulations.
Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
Works with in-house Technical Assistants, Special Investigators, Nurse
Consultants, Telephonic Case Managers and Team Supervisors to exceed customers' expectations for exceptional claim handling service.
Technical Skills & Competencies:
Entry-level Medical Only Claim Examiner position.
Knowledge of insurance, claims, and workers' compensation statutes, regulations, and compliance is a plus, but on-the-job training will be provided to the chosen applicant.
Ability to incorporate data analytics and modeling into daily activities to expedite the fair and equitable resolution of claims and claim issues.
A personal commitment to superior performance that adds value to our company and our customers.
Ability to work effectively with a wide variety of people.
An aptitude for evaluating, analyzing, and interpreting information.
Superior telephonic skills.
Excellent organizational skills.
The ability to multi-task with proven time management skills to meet deadlines.
Ability to work well in teams.
Demonstrate critical thinking and decision-making ability.
Excellent verbal and written communication skills.
Experience, Education, & Requirements:
Prior medical only or similar claim handling experience is a plus but not required.
Proficiency in using Microsoft Office Products
Experience in a fast-paced, fluid environment
Strong communication and telephonic skills
Knowledge of medical terminology is a plus but not required.
Knowledge of bill processing is a plus but not required.
If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.
Auto-ApplyIntake Certification Specialist
Claim processor job in East Hartford, CT
Intake/Certification Specialist (898A)
DEPARTMENT : Energy
FLSA STATUS: Non-Exempt
REPORTS TO: Assistant Program Manager Energy Services
The purpose of this position is to support the Agency's needs by scheduling customer appointments, conducting customer intake and performing tasks necessary to ascertain customer eligibility per program guidelines. Based on CRT's Steps to Success service delivery model, the Intake/Certification Specialist also provides customers with application assistance for and referrals to agency and community resources.
SPECIFIC DUTIES AND RESPONSIBILITIES
ESSENTIAL JOB FUNCTIONS
The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. It is not necessarily descriptive of any one position in the class. The omission of an essential function does not preclude management from assigning duties not listed herein if such functions are a logical assignment to the position.
Responds to all emergency cases within 24 hours of customer inquiry.
Responsible for responding to all non-emergency customer inquiry as stipulated in program guidelines.
Schedules and reschedules customer intake appointments, as needed.
Provides quality customer service.
As assigned, conducts customer intake and reviews customer application and accompanying documentation for accuracy and completeness and to ensure service eligibility as outlined in program rules and regulations.
Maintains orderly customer paper files in accordance with program requirements
Demonstrates proficiency in the use of available technology to maintain accurate computer-based files in accordance with agency and program requirements.
Refers customers to internal and external resources in support of comprehensive attention to customer need.
Processes energy applications using DSS procedural instructions.
Process energy applications per CRT's Quality Assurance procedures.
Prepares program reports in accordance with program requirements and agency need.
Possesses excellent oral and written communication skills that demonstrate the ability to communicate with persons of varying racial/ethnic and socio-economic cultures.
Attends courses, professional workshops/training, seminars and/or participates in self-directed studying that will provide for continuous professional growth related to this position.
Obtains/maintains valid certifications to sharpen and refresh job skills.
Performs outreach services and participates in community events and/or conducts community education sessions.
Maintains daily activity log.
ADDITIONAL JOB FUNCTIONS
Responds to supervisor, upper management and program funder requests for information as requested.
Some in-state travel may be required.
Performs all other duties as assigned.
MINIMUM TRAINING ANDEXPERIENCE
Education: Associate's Degree in human services or related field from an accredited two year college or university preferred. A high school diploma and work experience may be substituted for a college degree.
Demonstrated Skills: The ability to manage time in a fast-paced environment and accomplish job responsibilities under minimum supervision. Experience with non-profit or community volunteering. Must have strong listening, oral and written communication skills.
Bilingual: English/Spanish preferred.
Driving Required: Preferred Agency Vehicle: No Employee's Own Vehicle: Preferred
ADA COMPLIANCE
Physical Ability : Tasks involve the ability to exert very moderate physical effort in light work, typically involving some combination of stooping, kneeling, crouching and crawling, and which may involve some lifting, carrying, pushing and/or pulling of objects and materials of moderate weight (12-20 pounds).
Sensory Requirements : Some tasks require visual perception and discrimination. Some tasks require oral communications ability.
Environmental Factors : Tasks are regularly performed without exposure to adverse environmental conditions, such as dirt, dust, pollen, odors, wetness, humidity, rain, fumes, temperature and noise extremes, machinery, vibrations, electric currents, traffic hazards, animals/wildlife, toxic/poisonous agents, violence, disease, or pathogenic substances.
Acknowledgment
Signature indicates agreement with contents herein as being an accurate description of position duties and responsibilities.
_____________________________________
EMPLOYEE PRINTED NAME
_____________________________________ ____________________
EMPLOYEE SIGNATURE DATE
Signature indicates agreement with contents herein as being an accurate description of position duties and responsibilities.
_____________________________________
IMMEDIATE SUPERVISOR PRINTED NAME
_____________________________________ ____________________
IMMEDIATE SUPERVISOR SIGNATURE DATE
Community Renewal Team, Inc. is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, Community Renewal Team will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.
Auto-ApplyComplex Claims Specialist, Managed Care, E&O, D&O
Claim processor job in Weatogue, CT
Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business.
* This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change.
Responsibilities
* Analyzes, investigates and evaluates the loss to determine coverage and claim disposition.
* Utilizes proprietary claims management system to document claims and to diary future events or follow up.
* Issue detailed coverage position letters for all new claims within prescribed time frames.
* Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level.
* Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting.
* Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment.
* Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority.
* Participates in the claims audit process.
* Provides claims marketing services by meeting with brokers and insureds.
* As required, maintains insurance adjuster licenses
Qualifications
* Bachelors' and/or advanced degree
* 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers)
* Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge
* Functional knowledge of law and insurance regulations in various jurisdictions
* Demonstrated advanced verbal and written communications skills
* Demonstrated advanced analytical, decision making and negotiation skills
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
Auto-ApplyStop Loss & Health Claim Analyst
Claim processor job in Hartford, CT
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. 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. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
The Opportunity:
This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim.
The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources.
How you will contribute:
* Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
* The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions
* Maintain claim block and meet departmental production and quality metrics
* An awareness of industry claim practices
* Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records
* Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc.
* Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process
* Establish cooperative and productive relationships with professional resources
What you will bring with you:
* Bachelor's degree preferred
* A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing
* Demonstrated ability to work as part of a cohesive team
* Strong written and verbal communication skills
* Knowledge of Stop Loss Claims and Stop Loss industry preferred
* Demonstrated success in negotiation, persuasion, and solutions-based underwriting
* Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism
* Overall knowledge of health care industry
* Proficiency using the Microsoft Office suite of products
* Ability to travel
Salary Range: $54,900 - $82,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
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.
Job Category:
Claims - Life & Disability
Posting End Date:
30/01/2026
Auto-ApplyGeneral Liability Claim Representative
Claim processor job in Hartford, CT
Claims Representative - CH09CNAssociate Claim Representative - CH10DN
We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future.
As a General Liability Associate Claims Representative for all business lines, you're at the front lines for our customer. Your primary role is to investigate and manage claim files to help individuals and businesses prevail after a claim. The Hartford will provide you with a robust training and onboarding program, as well as ongoing coaching and development to ensure your success.
Start Date: February 16, 2026
Hours: 8am-5pm, Core Business hours to support either our Eastern or Western region, limited flexibility.
Virtual Training: 8 weeks, core business hours, your local time
This role will have a Hybrid work arrangement, with the expectation of working in an office location : (Hartford, CT / San Antonio, TX / Aurora (Naperville) IL/ Lake Mary, FL/ Scottsdale, AZ ) 3 days a week (Tuesday through Thursday).
Responsibilities:
Utilize active listening and critical thinking skills to quickly analyze customer needs
Leverage knowledge and resources to provide the appropriate solutions to requests
Take ownership to ensure that we go above and beyond in providing customer service
Utilize every touch point as an opportunity to build value and The Hartford brand
Commit to learning and developing
Develop an in depth understanding of Hartford products and business lines
Act as a liaison with other departments to resolve problems
Secure essential facts about losses
Negotiate settlements
Interpret, understand and explain coverage to policyholders
Efficiently update and move files to closure
Manage pending claims to meet company quality criteria
Ensure payments are processed timely as needed or input payments within authority
Special assignments or projects as assigned
May be required to assist in catastrophe situations
Develop proficiency and capabilities expected during new hire ramp-up period
Must demonstrate strong customer service focus
Ability to operate, lead and coach within The Hartford Way management system
Qualifications:
High School Diploma required; college degree preferred
Minimum of 1 year of related customer service experience or applicable insurance experience
Excellent oral, written and interpersonal communication
Demonstrated capacity to multi-task in a structured work environment
Ability to utilize multiple systems to handle/process claims
Problem solving and critical thinking skills are a must
Strong attention to detail
Additional Information:
As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance Claims in the states supported by your office. Continued employment with The Hartford is contingent upon the successful passage of the Licensing exam(s) within 30 business days from the completion of the licensing training.
Compensation
The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford's total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:
$45,280 - $79,320
The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience.
Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age
About Us | Our Culture | What It's Like to Work Here | Perks & Benefits
Auto-ApplyComplex Claims Specialist - Cyber, Technology, Media & Crime
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 $140,000 - $155,000 (Boston, Manhattan, West Hartford)
Salary range $125,000-$135,000 (Chicago, Atlanta)
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-AJ1
Work with amazing people and be part of a unique culture
Auto-ApplyClaims Examiner, Commercial General Liability
Claim processor job in Hartford, CT
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
Arch Insurance Group Inc., AIGI, has an opening with the Claims Division on the Mid Corp Casualty Team as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing commercial claims for medium severity, and general liability, as well as the associated excess and umbrella policies, in jurisdictions throughout the United States.
Responsibilities
* Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis
* Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
* Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures
* Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary
* Investigate claims and review the insureds' materials, pleadings, and other relevant documents
* Identify and review each jurisdiction's applicable statutes, rules, and case law
* Review litigation materials including depositions and expert's reports
* Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
* Retain counsel when necessary and direct counsel in accordance with resolution strategy
* Analyze coverage, liability and damages for purposes of assessing and recommending reserves
* Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves
* Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter
* Negotiate resolution of claims
* Select and utilize structure brokers
* Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims
Experience & Required Skills
* Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
* Strong time management and organizational skills
* Demonstrated ability to take part in active strategic discussions
* Demonstrated ability to work well independently and in a team environment
* Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
* Willing and able to travel 10%
Education
* Bachelor's degree or 6 years of commercial Claims experience in lieu of degree
* Three to five (3-5) years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims; with Casualty and Construction a plus
* Proper & active adjuster licensing in all applicable states
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$85,000 - $115,000
* Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
* Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
For Colorado Applicants - The deadline to submit your application is:
December 31, 2025
14400 Arch Insurance Group Inc.
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