Senior Claims Analyst
Claim processor job in Washington, DC
Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with:
Furnishes reports with supporting information necessary to resolve disputes or defend against the claims,
Prepares and assembles appeal files,
Participates in meetings or negotiations with claimants,
Appears in legal proceedings,
Prepares cost estimates for use in claims negotiations,
Prepares risk assessments/analysis relative to claim exposures,
Prepares findings of fact and other documentation required by the CO.
Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models.
Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred.
Submit resumes and project list in MS Word or PDF format:
Please No Calls
Submarine Certification Specialist - Washington, D.C.
Claim processor job in Washington, DC
Looking for an opportunity at a place you can have influence and make a difference every day? Then Serco has the right opportunity for you! As the Program Analyst (Submarines), you will provide programmatic support to one of our NAVSEA customers in the Washington, DC area. Bring your expertise and collaborative skills to make an impact towards our military defense and safety of our sailors.
Serco is the prime on the SHAPM contract which deals with acquisition and construction of submarines. The Team Submarine concept unifies once diverse submarine-related activities into a single submarine-centric organization with the goal of eliminating traditional stovepipe structures and processes that created impediments and inefficiencies in the submarine research, development, acquisition, and maintenance communities. Team Submarine provides improved communication among the various offices that contribute to the overall success of the United States Submarine Force.
**In this role, you will:**
+ Provide Engineering and Technical support coordinating all matters relating to preparation, review and approval of Ship Certification correspondence for Fast Cruise and Sea Trials, Follow-On certifications and URO certifications.
+ Coordinate routing and processing of all ship certification documents for concurrence and approval signatures.
+ Prepare coordinated reports, presentations and briefings in support of program actions.
+ Analyzes requirements to develop program reporting including specifications, data gathering and analytical techniques, and evaluation methodology.
+ Support studies, surveys, reviews, and/or research projects to evaluate program accomplishments, effectiveness, and/or compliance with meeting specific goals, objectives, rules, and regulations.
+ Develop evaluation plans, metrics, procedures, and methodology as a result of studies performed.
+ Provide Subject Matter Expert (SME) support and assist the Government with technical analyses, inquiries, research, testing, data validation for any matters relating to US submarines.
+ Maintain applicable Plans of Actions and Milestones (POA&M) as directed/required.
+ Interface with stakeholders to identify, assign, and track action items, leveraging initiatives to benefit submarine sustainment support.
+ Collect information and provide recommendations to senior decision-makers through well-written documents.
+ Communicate with various Program Office representatives within NAVSEA and other Department of Navy organization in supporting PM concerns.
+ Coordinate with the technical community and develop white papers and presentations for the Government and the Navy on program status or issues impacting the program.
+ Organize and maintain Program tracking files/tools on program status, actions items and issues.
+ Support the team in performing additional duties and responsibilities as assigned.
+ Provide timely and efficient responses for all urgent tasking.
+ Ensure program correspondence and deliverables are in accordance with Serco's Quality Assurance Program.
Meet Your Recruiter! (https://serco.kzoplatform.com/player/medium/**********002817285?embed=true&layout=fullscreen&overlay=false&auth=public)
**Qualifications**
**To be successful in this role you will have:**
+ Ability to obtain and maintain an active DoD Secret clearance.
+ US Citizenship
+ Bachelor's Degree
+ An Associate's Degree and 2 years of additional experience will be considered in lieu of Bachelor's Degree or a High School Diploma/GED and 4 years of additional experience will be considered in lieu of Bachelor's Degree.
+ 8 years of experience (Experience with Navy acquisition and/or In-Service Programs highly preferred)
+ Strong customer, interpersonal and organizational level communication skills (written and verbal).
+ Proficiency with Microsoft Office Suite programs, to include Excel and PowerPoint.
+ Written communication skills (e.g., drafting program impact statements and Congressional Appeals)
+ Experience leading a project and interfacing with an end item customer.
+ Ability to travel at least 10% of the time.
**Additional desired experience and skills:**
+ Active-Duty experience in submarine service (preferably SSN) is a plus.
+ Recent experience in Team Submarine would be ideal.
If you are interested in supporting and working with our military and sailors and a passionate Serco team- then submit your application now for immediate consideration. It only takes a few minutes and could change your career!
**Company Overview**
Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco's 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.
To review Serco benefits please visit: *********************************************************** . If you require an accommodation with the application process please email: ******************** or call the HR Service Desk at ************, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see our Applicant Privacy Policy and Notice (**************************************** .
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email ********************* .
Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
**Pay Transparency**
Our Total Rewards package includes competitive pay, performance-based incentives, and benefits that promote well-being and work-life balance-so you can thrive both professionally and personally. Eligible employees also gain access to a wide range of benefits from comprehensive health coverage and health savings accounts to retirement plans, life and disability insurance, and time-off programs that support work-life balance. Program availability may vary based on factors such as contract type, location, hire date, and applicable collective bargaining agreements.
Salary range: The range for this position can be found at the top of the posting. This range is provided as a general guideline and represents a good faith estimate across all experience levels. Actual base salary will be determined by a variety of factors, including but not limited to, the scope of the role, relevant experience, job-related knowledge, education and training, key skills, and geographic market considerations. For roles available in multiple states, the range may vary to reflect differences in local labor markets. In addition to base salary, eligible positions may include other forms of compensation such as annual bonuses or long-term incentive opportunities.
Benefits HIGHLIGHTS - Comprehensible Benefits for Full-time Employees (Part-time members receive a customized package tailored to their role).
+ Medical, dental, and vision insurance
+ Robust vacation and sick leave benefits, and flexible work arrangements where permitted by role or contract
+ 401(k) plan that includes employer matching funds
+ Tuition reimbursement program
+ Life insurance and disability coverage
+ Optional coverages you can buy, including pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection
+ Birth, adoption, parental leave benefits
+ Employee Assistance Plan that includes counseling conditions
+ Specific benefits are dependent upon the specific contract as well as whether the position is covered by a collective bargaining agreement or the Service Contract Act.
To review all Serco benefits please visit: ***************************************** .
Serco complies with all applicable state and local leave laws, including providing time off under the Colorado Healthy Families and Workplaces Act for eligible Colorado residents, in alignment with our policies and benefit plans. The application window for this position is for no more than 60 days. We encourage candidates to apply promptly after the posting date, as the position may close earlier if filled or if the application volume exceeds expectations. Please submit applications exclusively through Serco's external (or internal) career site. This is a U.S.-based role. If an applicant has any concerns with job posting compliance, please send an email to: ******************** .
Click here to apply now (**************************************************************************************************************************************************************
**New to Serco?**
Join our Talent Community! (***************************************************
**ID** _72127_
**Recruiting Location : Location** _US-DC-Washington_
**Category** _Project/Program Management_
**Position Type** _Full-Time_
**Security Clearance** _Other_
**Clearance Details** _Ability to obtain and maintain an active DoD Secret clearance._
**Telework** _No - Teleworking not available for this position_
**Campaign** _LPMETS_
**Salary Range/Amount** _$103369.00 - $167974.00_
Easy ApplyExperienced Outside Property Claim Representative
Claim processor job in Washington, DC
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$67,000.00 - $110,600.00
**Target Openings**
1
**What Is the Opportunity?**
This position could be eligible for a sign on bonus.
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
**What Will You Do?**
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May provides mentoring and coaching to less experienced claim professionals.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
+ This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree preferred.
+ General knowledge of estimating system Xactimate preferred.
+ Two or more years of previous outside property claim handling experience preferred.
+ Interpersonal and customer service skills - Advanced
+ Organizational and time management skills- Advanced
+ Ability to work independently - Intermediate
+ Judgment, analytical and decision making skills - Intermediate
+ Negotiation skills - Intermediate
+ Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
+ Investigative skills - Intermediate
+ Ability to analyze and determine coverage - Intermediate
+ Analyze, and evaluate damages -Intermediate
+ Resolve claims within settlement authority - Intermediate
+ Valid passport preferred.
**What is a Must Have?**
+ High School Diploma or GED required.
+ A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
+ Valid driver's license required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Records Examiner
Claim processor job in Washington, DC
SGI Global is seeking a Records Examiner to provide data entry, records and data analysis support for the Executive Office for the United States Attorneys' Office. The position is based in Washington DC. The Records Examiner position will support the client by providing a wide variety of clerical and administrative assistance services. The work requires knowledge of processes, procedures, and practices associated with accessing databases, data entry, administrative office skills, attention to detail, quality control techniques to ensure accuracy, and the ability to work independently.
Responsibilities
The Records Examiner/Analyst contract position will support the FLPs by performing data entry services as well as evaluation and analytical services, including, but not limited to, the following:
Perform functions of Data Analyst as stated herein.
Analyze debtor's ability to pay a debt based upon Government collection standards and asset and liability information provided by third party information searches. Based on analysis, make recommendations to the FLP regarding collectability of a debt.
Create and manipulate spreadsheets to report completed work and/or support analysis.
Produce a variety of written documents and materials utilizing a wide range of office software applications. Assignments may include integrating output from different database applications, charts, and graphs into word processing documents, presentations, or spreadsheets. Ensure proper format, spelling, punctuation, capitalization, and grammar of all written documents.
Establish high dollar complex civil debts in the debt collection database in accordance with guidance provided by the FLPs and the Government Program Manager and information on the official internal office referral form. This work includes adding all appropriate payee information for both federal and non-federal payees, ensuring that amounts allocated to payees are accurate and match amounts on the referral form.
Process transfer debts from other DOJ litigating divisions in accordance with guidance provided by the FLPs and the Government Program Manager. This work includes a review of information as well as generating and emailing instructions for FedWire or Pay.gov.
Assume administrative responsibilities for special assessment only debts and low dollar debts (i.e., $2,500 and lower). This time sensitive and critical work requires monthly monitoring of cases.
Monitor the status of debtor payment plans to identify deficiencies and call or send delinquent payment reminders to debtors.
Communicate in a professional and courteous manner with the Office of Legal Programs management, Government officials, and/or delinquent judgment debtors.
Perform other duties as assigned.
The Contractor shall provide Records Examiner/Analyst support positions with the following knowledge, skills, and abilities to perform the duties as specified herein.
Possess a four-year undergraduate degree, with a minimum of three (3) years of professional work experience, including data entry responsibilities. Four-year degree may be substituted with two (2) years of work experience as a Data Analyst.
Work independently and efficiently, with the ability to multi-task and prioritize a shifting workload.
Retrieve and analyze data and information from multiple sources.
Attention to detail and quality control techniques to ensure accuracy.
Excellent written and oral communication skills.
A good working knowledge of legal procedures as well as civil and criminal case terminology.
Proficient in Microsoft Office software programs (i.e., Word, PowerPoint, Excel, and Outlook) and in accessing, learning, and maintaining various databases and on-line resource search engines.
Operate a variety of office equipment, including personal computers, photocopiers, telephone systems, and scanners.
Perform editing, reformatting, and generating written and electronic documents using MS Word and other document generation software.
SGI Global provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.
Experienced Outside Property Claim Representative - Washington, DC
Claim processor job in Washington, DC
ATTENTION MILITARY AFFILIATED JOB SEEKERS
- Our organization works with partner companies to source qualified talent for their open roles. The following position is available to
Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers
. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$67,000.00 - $110,600.00
What Is the Opportunity?
This position could be eligible for a sign on bonus.
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
What Will You Do?
Handles 1st party property claims of moderate severity and complexity as assigned.
Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
Broad scale use of innovative technologies.
Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Establishes timely and accurate claim and expense reserves.
Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
Writes denial letters, Reservation of Rights and other complex correspondence.
Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
Meets all quality standards and expectations in accordance with the Knowledge Guides.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
Manages file inventory to ensure timely resolution of cases.
Handles files in compliance with state regulations, where applicable.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
Identifies and refers claims with Major Case Unit exposure to the manager.
Performs administrative functions such as expense accounts, time off reporting, etc. as required.
Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
May provides mentoring and coaching to less experienced claim professionals.
May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
Must secure and maintain company credit card required.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
Perform other duties as assigned.
Additional Qualifications/Responsibilities
What Will Our Ideal Candidate Have?
Bachelor's Degree preferred.
General knowledge of estimating system Xactimate preferred.
Two or more years of previous outside property claim handling experience preferred.
Interpersonal and customer service skills - Advanced
Organizational and time management skills- Advanced
Ability to work independently - Intermediate
Judgment, analytical and decision making skills - Intermediate
Negotiation skills - Intermediate
Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
Investigative skills - Intermediate
Ability to analyze and determine coverage - Intermediate
Analyze, and evaluate damages -Intermediate
Resolve claims within settlement authority - Intermediate
Valid passport preferred.
What is a Must Have?
High School Diploma or GED required.
A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
Valid driver's license required.
What Is in It for You?
Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Senior Claim Benefit Specialist
Claim processor job in Washington, DC
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
And we do it all with heart, each and every day.
Position SummaryReview and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.
Process provider refunds and returned checks.
May handle customer service inquiries and problems.
Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise.
Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process.
Performs claim re-work calculations.
Follow through completion of claim overpayments, underpayments, and any other irregularities.
Process complex non-routine Provider Refunds and Returned Checks.
Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks.
Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals.
Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures.
Review and handle relevant correspondences assigned to the team that may result in adjustment to claims.
May provide job shadowing to lesser experience staff.
Utilize all resource materials to manage job responsibilities.
Required Qualifications2+ years medical claim processing experience.
Experience in a production environment.
Demonstrated ability to handle multiple assignments competently, accurately, and efficiently.
Effective communications, organizational, and interpersonal skills.
Preferred QualificationsDG system claims processing experience.
Associate degree preferred.
EducationHigh School Diploma or GED.
Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18.
50 - $42.
35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future.
Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.
In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on: 12/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Records Examiner
Claim processor job in Washington, DC
Job Description
SGI Global is seeking a Records Examiner to provide data entry, records and data analysis support for the Executive Office for the United States Attorneys' Office. The position is based in Washington DC. The Records Examiner position will support the client by providing a wide variety of clerical and administrative assistance services. The work requires knowledge of processes, procedures, and practices associated with accessing databases, data entry, administrative office skills, attention to detail, quality control techniques to ensure accuracy, and the ability to work independently.
Responsibilities
The Records Examiner/Analyst contract position will support the FLPs by performing data entry services as well as evaluation and analytical services, including, but not limited to, the following:
Perform functions of Data Analyst as stated herein.
Analyze debtor's ability to pay a debt based upon Government collection standards and asset and liability information provided by third party information searches. Based on analysis, make recommendations to the FLP regarding collectability of a debt.
Create and manipulate spreadsheets to report completed work and/or support analysis.
Produce a variety of written documents and materials utilizing a wide range of office software applications. Assignments may include integrating output from different database applications, charts, and graphs into word processing documents, presentations, or spreadsheets. Ensure proper format, spelling, punctuation, capitalization, and grammar of all written documents.
Establish high dollar complex civil debts in the debt collection database in accordance with guidance provided by the FLPs and the Government Program Manager and information on the official internal office referral form. This work includes adding all appropriate payee information for both federal and non-federal payees, ensuring that amounts allocated to payees are accurate and match amounts on the referral form.
Process transfer debts from other DOJ litigating divisions in accordance with guidance provided by the FLPs and the Government Program Manager. This work includes a review of information as well as generating and emailing instructions for FedWire or Pay.gov.
Assume administrative responsibilities for special assessment only debts and low dollar debts (i.e., $2,500 and lower). This time sensitive and critical work requires monthly monitoring of cases.
Monitor the status of debtor payment plans to identify deficiencies and call or send delinquent payment reminders to debtors.
Communicate in a professional and courteous manner with the Office of Legal Programs management, Government officials, and/or delinquent judgment debtors.
Perform other duties as assigned.
The Contractor shall provide Records Examiner/Analyst support positions with the following knowledge, skills, and abilities to perform the duties as specified herein.
Possess a four-year undergraduate degree, with a minimum of three (3) years of professional work experience, including data entry responsibilities. Four-year degree may be substituted with two (2) years of work experience as a Data Analyst.
Work independently and efficiently, with the ability to multi-task and prioritize a shifting workload.
Retrieve and analyze data and information from multiple sources.
Attention to detail and quality control techniques to ensure accuracy.
Excellent written and oral communication skills.
A good working knowledge of legal procedures as well as civil and criminal case terminology.
Proficient in Microsoft Office software programs (i.e., Word, PowerPoint, Excel, and Outlook) and in accessing, learning, and maintaining various databases and on-line resource search engines.
Operate a variety of office equipment, including personal computers, photocopiers, telephone systems, and scanners.
Perform editing, reformatting, and generating written and electronic documents using MS Word and other document generation software.
SGI Global provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.
Job Posted by ApplicantPro
Submarine Certification Specialist - Washington, D.C.
Claim processor job in Washington, DC
Looking for an opportunity at a place you can have influence and make a difference every day? Then Serco has the right opportunity for you! As the Program Analyst (Submarines), you will provide programmatic support to one of our NAVSEA customers in the Washington, DC area. Bring your expertise and collaborative skills to make an impact towards our military defense and safety of our sailors.
Serco is the prime on the SHAPM contract which deals with acquisition and construction of submarines. The Team Submarine concept unifies once diverse submarine-related activities into a single submarine-centric organization with the goal of eliminating traditional stovepipe structures and processes that created impediments and inefficiencies in the submarine research, development, acquisition, and maintenance communities. Team Submarine provides improved communication among the various offices that contribute to the overall success of the United States Submarine Force.
In this role, you will:
* Provide Engineering and Technical support coordinating all matters relating to preparation, review and approval of Ship Certification correspondence for Fast Cruise and Sea Trials, Follow-On certifications and URO certifications.
* Coordinate routing and processing of all ship certification documents for concurrence and approval signatures.
* Prepare coordinated reports, presentations and briefings in support of program actions.
* Analyzes requirements to develop program reporting including specifications, data gathering and analytical techniques, and evaluation methodology.
* Support studies, surveys, reviews, and/or research projects to evaluate program accomplishments, effectiveness, and/or compliance with meeting specific goals, objectives, rules, and regulations.
* Develop evaluation plans, metrics, procedures, and methodology as a result of studies performed.
* Provide Subject Matter Expert (SME) support and assist the Government with technical analyses, inquiries, research, testing, data validation for any matters relating to US submarines.
* Maintain applicable Plans of Actions and Milestones (POA&M) as directed/required.
* Interface with stakeholders to identify, assign, and track action items, leveraging initiatives to benefit submarine sustainment support.
* Collect information and provide recommendations to senior decision-makers through well-written documents.
* Communicate with various Program Office representatives within NAVSEA and other Department of Navy organization in supporting PM concerns.
* Coordinate with the technical community and develop white papers and presentations for the Government and the Navy on program status or issues impacting the program.
* Organize and maintain Program tracking files/tools on program status, actions items and issues.
* Support the team in performing additional duties and responsibilities as assigned.
* Provide timely and efficient responses for all urgent tasking.
* Ensure program correspondence and deliverables are in accordance with Serco's Quality Assurance Program.
Meet Your Recruiter!
Qualifications
To be successful in this role you will have:
* Ability to obtain and maintain an active DoD Secret clearance.
* US Citizenship
* Bachelor's Degree
* An Associate's Degree and 2 years of additional experience will be considered in lieu of Bachelor's Degree or a High School Diploma/GED and 4 years of additional experience will be considered in lieu of Bachelor's Degree.
* 8 years of experience (Experience with Navy acquisition and/or In-Service Programs highly preferred)
* Strong customer, interpersonal and organizational level communication skills (written and verbal).
* Proficiency with Microsoft Office Suite programs, to include Excel and PowerPoint.
* Written communication skills (e.g., drafting program impact statements and Congressional Appeals)
* Experience leading a project and interfacing with an end item customer.
* Ability to travel at least 10% of the time.
Additional desired experience and skills:
* Active-Duty experience in submarine service (preferably SSN) is a plus.
* Recent experience in Team Submarine would be ideal.
If you are interested in supporting and working with our military and sailors and a passionate Serco team- then submit your application now for immediate consideration. It only takes a few minutes and could change your career!
Company Overview
Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco's 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.
To review Serco benefits please visit: ************************************************************ If you require an accommodation with the application process please email: ******************** or call the HR Service Desk at ************, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see our Applicant Privacy Policy and Notice.
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email *********************.
Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
Pay Transparency
Our Total Rewards package includes competitive pay, performance-based incentives, and benefits that promote well-being and work-life balance-so you can thrive both professionally and personally. Eligible employees also gain access to a wide range of benefits from comprehensive health coverage and health savings accounts to retirement plans, life and disability insurance, and time-off programs that support work-life balance. Program availability may vary based on factors such as contract type, location, hire date, and applicable collective bargaining agreements.
Salary range: The range for this position can be found at the top of the posting. This range is provided as a general guideline and represents a good faith estimate across all experience levels. Actual base salary will be determined by a variety of factors, including but not limited to, the scope of the role, relevant experience, job-related knowledge, education and training, key skills, and geographic market considerations. For roles available in multiple states, the range may vary to reflect differences in local labor markets. In addition to base salary, eligible positions may include other forms of compensation such as annual bonuses or long-term incentive opportunities.
Benefits HIGHLIGHTS - Comprehensible Benefits for Full-time Employees (Part-time members receive a customized package tailored to their role).
* Medical, dental, and vision insurance
* Robust vacation and sick leave benefits, and flexible work arrangements where permitted by role or contract
* 401(k) plan that includes employer matching funds
* Tuition reimbursement program
* Life insurance and disability coverage
* Optional coverages you can buy, including pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection
* Birth, adoption, parental leave benefits
* Employee Assistance Plan that includes counseling conditions
* Specific benefits are dependent upon the specific contract as well as whether the position is covered by a collective bargaining agreement or the Service Contract Act.
To review all Serco benefits please visit: ******************************************
Serco complies with all applicable state and local leave laws, including providing time off under the Colorado Healthy Families and Workplaces Act for eligible Colorado residents, in alignment with our policies and benefit plans. The application window for this position is for no more than 60 days. We encourage candidates to apply promptly after the posting date, as the position may close earlier if filled or if the application volume exceeds expectations. Please submit applications exclusively through Serco's external (or internal) career site. This is a U.S.-based role. If an applicant has any concerns with job posting compliance, please send an email to: ********************.
Easy ApplyExperienced Outside Property Claim Representative
Claim processor job in Washington, DC
Who Are We?
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Job CategoryClaimCompensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range$67,000.00 - $110,600.00Target Openings1What Is the Opportunity?This position could be eligible for a sign on bonus.
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.What Will You Do?
Handles 1st party property claims of moderate severity and complexity as assigned.
Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
Broad scale use of innovative technologies.
Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Establishes timely and accurate claim and expense reserves.
Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
Writes denial letters, Reservation of Rights and other complex correspondence.
Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
Meets all quality standards and expectations in accordance with the Knowledge Guides.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
Manages file inventory to ensure timely resolution of cases.
Handles files in compliance with state regulations, where applicable.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
Identifies and refers claims with Major Case Unit exposure to the manager.
Performs administrative functions such as expense accounts, time off reporting, etc. as required.
Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
May provides mentoring and coaching to less experienced claim professionals.
May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
Must secure and maintain company credit card required.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
Perform other duties as assigned.
What Will Our Ideal Candidate Have?
Bachelor's Degree preferred.
General knowledge of estimating system Xactimate preferred.
Two or more years of previous outside property claim handling experience preferred.
Interpersonal and customer service skills - Advanced
Organizational and time management skills- Advanced
Ability to work independently - Intermediate
Judgment, analytical and decision making skills - Intermediate
Negotiation skills - Intermediate
Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
Investigative skills - Intermediate
Ability to analyze and determine coverage - Intermediate
Analyze, and evaluate damages -Intermediate
Resolve claims within settlement authority - Intermediate
Valid passport preferred.
What is a Must Have?
High School Diploma or GED required.
A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
Valid driver's license required.
What Is in It for You?
Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit *********************************************************
Auto-ApplyClaims Representative (IAP) - Workers Compensation Training Program
Claim processor job in Washington, DC
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Claims Representative (IAP) - Workers Compensation Training Program
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
+ A stable and consistent work environment in an office setting.
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities.
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due.
**ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Attendance and completion of designated classroom claims professional training program.
+ Performs on-the-job training activities including:
+ Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims.
+ Adjusting low and mid-level liability and/or physical damage claims under close supervision.
+ Processing disability claims of minimal disability duration under close supervision.
+ Documenting claims files and properly coding claim activity.
+ Communicating claim action/processing with claimant and client.
+ Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned.
+ Participates in rotational assignments to provide temporary support for office needs.
**QUALIFICATIONS**
Bachelor's or Associate's degree from an accredited college or university preferred.
**EXPERIENCE**
Prior education, experience, or knowledge of:
- Customer Service
- Data Entry
- Medical Terminology (preferred)
- Computer Recordkeeping programs (preferred)
- Prior claims experience (preferred)
Additional helpful experience:
- State license if required (SIP, Property and Liability, Disability, etc.)
- WCCA/WCCP or similar designations
- For internal colleagues, completion of the Sedgwick Claims Progression Program
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum
+ An assigned mentor and manager that will support and guide you on your career journey
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Outside Property Claim Representative Trainee
Claim processor job in Washington, DC
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$52,600.00 - $86,800.00
**Target Openings**
1
**What Is the Opportunity?**
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington, DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
**What Will You Do?**
+ Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
+ The on the job training includes practice and execution of the following core assignments:
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
+ This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience.
+ Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic.
+ Verbal and written communication skills -Intermediate.
+ Attention to detail ensuring accuracy - Basic.
+ Ability to work in a high volume, fast paced environment managing multiple priorities - Basic.
+ Analytical Thinking - Basic.
+ Judgment/ Decision Making - Basic.
+ Valid passport.
**What is a Must Have?**
+ High School Diploma or GED and one year of customer service experience OR Bachelor's Degree.
+ Valid driver's license.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Claims Analyst I
Claim processor job in Washington, DC
JOB TITLE: Claims Analyst
This position is responsible for assisting with following up on administrative appeals and documentation submitted to health insurers and governmental payers; working well with attorneys and paralegals; maintaining the workload.
DUTIES AND RESPONSIBILITIES:
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Determines action required to resolve the underpayment and initiate that action, including submitting appeals and reconsideration requests.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement
Quickly and efficiently prepares, reviews, and submits well-written claims correspondence and related documents to insurers
Is skilled, aggressive, cordial, and professional on the telephone to follow up on submitted appeals.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required :
BA/BS with a GPA of 3.0 or higher.
Interest in healthcare and healthcare law.
Able to navigate through various computer systems and applications to find information about insurance claims.
Ability to prioritize and multi-task.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Excellent organizational and time management skills.
High attention to detail.
Clear, concise, and logical writing style.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
External Working Relationships - Develops and maintains courteous and effective working relationships with clients, vendors and/or any other representatives of external organizations.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
Auto-ApplyClaims Analyst I
Claim processor job in Washington, DC
Job Description
JOB TITLE: Claims Analyst
This position is responsible for assisting with following up on administrative appeals and documentation submitted to health insurers and governmental payers; working well with attorneys and paralegals; maintaining the workload.
DUTIES AND RESPONSIBILITIES:
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Determines action required to resolve the underpayment and initiate that action, including submitting appeals and reconsideration requests.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement
Quickly and efficiently prepares, reviews, and submits well-written claims correspondence and related documents to insurers
Is skilled, aggressive, cordial, and professional on the telephone to follow up on submitted appeals.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required:
BA/BS with a GPA of 3.0 or higher.
Interest in healthcare and healthcare law.
Able to navigate through various computer systems and applications to find information about insurance claims.
Ability to prioritize and multi-task.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Excellent organizational and time management skills.
High attention to detail.
Clear, concise, and logical writing style.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
External Working Relationships - Develops and maintains courteous and effective working relationships with clients, vendors and/or any other representatives of external organizations.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
Claims Specialist
Claim processor job in Washington, DC
This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.
DUTIES AND RESPONSIBILITIES:
Investigates Claims Denials.
Handles large volumes of documents, including accurately scanning and mailing documents.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement.
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
Opens, sorts, and imports incoming correspondence into the office database.
Navigates through various computer systems and applications to find information about insurance claims.
Greets and assists onsite guests.
Answers calls for Claim status and Appeal status.
Performs any other administrative duties as may be necessary.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required :
Previous experience in office administration or another related field.
Basic working knowledge of the US healthcare system.
Ability to prioritize and multitask.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Highly attentive to detail.
Excellent organizational and time management skills.
Clear, concise, and logical writing style.
Computer-savvy, able to learn new applications/software quickly.
Please remove paragraph before using in Workplace
COMPETENCIES: Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each . Then select an additional 3-5 of the most critical competencies for the specific job title.
Please note: You may remove complete statements and complete sub-title sections however the verbiage/content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Auto-ApplyClaims Specialist
Claim processor job in Washington, DC
SUMMARY:
This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.
DUTIES AND RESPONSIBILITIES:
Investigates Claims Denials.
Handles large volumes of documents, including accurately scanning and mailing documents.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement.
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
Opens, sorts, and imports incoming correspondence into the office database.
Navigates through various computer systems and applications to find information about insurance claims.
Greets and assists onsite guests.
Answers calls for Claim status and Appeal status.
Performs any other administrative duties as may be necessary.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required:
Previous experience in office administration or another related field.
Basic working knowledge of the US healthcare system.
Ability to prioritize and multitask.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Highly attentive to detail.
Excellent organizational and time management skills.
Clear, concise, and logical writing style.
Computer-savvy, able to learn new applications/software quickly.
Please remove paragraph before using in Workplace
COMPETENCIES: Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each . Then select an additional 3-5 of the most critical competencies for the specific job title.
Please note: You may remove complete statements and complete sub-title sections however the verbiage/content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.