Claim processor jobs in Hamden, CT

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence. Responsibilities: * Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level * Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution * Review and analyze supporting damage documentation * Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions * Establish appropriate loss and expense reserves with documented rationale * Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines Experience & Qualifications * Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word * Knowledge of ImageRight preferred * Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions * Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines * Ability to work well independently and in a team environment * Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date. Education * Bachelor's degree preferred * 3-5 years' experience handling the process of commercial insurance claims #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $71,900 - $97,110/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

Sr. Claims Analyst, Environmental Casualty - (25000048) Description Location: New York, NY, New Jersey, Farmington, CT, or other Allied World office locations. Job Summary:Investigate, evaluate, and resolve claims asserted against the Company's environmental policies. Engage in collaborative projects in support of other areas of the company, including underwriting, finance and accounting, actuarial, operations, and technology. Provide superior service to all customers, whether internal or external. Job Responsibilities:· Efficiently manage a vigorous load of claims involving a broad spectrum of accounts and coverages. Promptly analyze coverage, draft accurate and timely coverage positions, and manage litigation by effectively interacting with insureds, brokers, defense counsel, underwriters and other parties as required. Establish timely and appropriate reserves and regularly report claim developments and trends to claims and underwriting management. Represent Company in the resolution of claims and participate in legal proceedings, including mediations. · Work with other areas of the Company including underwriting, finance and accounting, actuarial, operations and technology on projects as requested. Prepare claim summaries and other reports as necessary for management. Prepare Executive Claim reports and present on a quarterly basis to senior executives. · Meet with existing or prospective clients and brokers. Attend relevant industry conferences/meetings. Qualifications CompensationThe below annualized base pay range is a broad range based on analysis of similar positions in the market. The actual base pay for the position may be above or below he listed range and determined by a number of considerations, including but now limited to complexity, location, and scope of the role, along with experience, skills, education, training, and other conditions of employment. Base salary represents one compensation of Allied World comprehensive total reward package, which may also include annual incentive compensation rewards. The salary range is flexible and will be determined according to the candidate's experience. $105,000 - $113,000Qualifications:· Minimum of 2 years' experience handling claims. · Four-year college degree is required. Knowledge of claims, legal and coverage issues in all U. S. jurisdictions. Excellent negotiation and communication skills. Strong technical skills and writing experience. Proficient with Microsoft Office products, internet research. Ability to accurately and timely analyze coverage, draft coverage position letters and interact and collaborate with counsel regarding litigation and coverage strategies, negotiate and resolve claims and otherwise act within the scope of delegated authority. Compliance with multi-state adjuster licensing requirements. Some travel required. About FairfaxFairfax is a holding company which, through its subsidiaries, is engaged in property and casualty insurance and reinsurance and investment management. About Allied WorldAllied World Assurance Company Holdings, Ltd, through its subsidiaries, is a global provider of insurance and reinsurance solutions. We operate under the brand Allied World and have supported clients, cedents and trading partners with thoughtful service and meaningful coverages since 2001. We are a subsidiary of Fairfax Financial Holdings, Limited and benefit from a strong capital base and a worldwide network of affiliated entities that allow us to think and respond in non-traditional ways. Our generous benefits package includes Health, Dental and Disability Insurance, a company match 401k plan, and Group Term Life Insurance. Allied World is an Equal Opportunity Employer. All qualified applicants will be considered for employment without consideration of any disability, veteran status or any other characteristic protected by law. To learn more, visit awac. com, or follow us on Facebook at facebook. com/alliedworld and LinkedIn at linkedin. com/company/allied-world. Primary Location: US-NY-New YorkOther Locations: US-CT-Farmington, US-NJ-IselinWork Locations: New York 199 Water Street New York 10038Job: ClaimsEmployee Status:RegularJob Type:StandardJob Posting: Oct 31, 2025, 1:02:59 PMMaximum Salary113,000. 00Pay BasisYearly

Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business. *This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change. Responsibilities Analyzes, investigates and evaluates the loss to determine coverage and claim disposition. Utilizes proprietary claims management system to document claims and to diary future events or follow up. Issue detailed coverage position letters for all new claims within prescribed time frames. Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level. Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting. Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment. Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority. Participates in the claims audit process. Provides claims marketing services by meeting with brokers and insureds. As required, maintains insurance adjuster licenses Qualifications Bachelors' and/or advanced degree 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers) Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge Functional knowledge of law and insurance regulations in various jurisdictions Demonstrated advanced verbal and written communications skills Demonstrated advanced analytical, decision making and negotiation skills About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Claims Specialist, Professional Liability (also open to Senior Claims Specialist level) Hartford, CT Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle the most complex claims seamlessly. How do you make a good thing better? You focus on excellence and creating a culture of continuous improvement. You create an environment that fosters collaboration, customer service and colleague development. As a Claims Specialist (also open to Senior Claims Specialist level) in the Hartford Professional claims unit, you will play a critical role by managing and resolving claims under various types of primary and excess professional liability policies, which could include public company directors & officers ("D&O") liability policies; financial institution D&O and errors & omissions ("E&O") policies; insurance company and insurance agents & brokers E&O policies; fiduciary liability policies; and employment practices liability policies. You will work closely with your manager to bring claims to resolution. You will interact and collaborate with regional practice leaders, our professional underwriters, brokers and clients on assigned accounts, taking ownership of critical issues relating to claims management. Our professional liability claims handlers are tasked with resolving and settling claims proactively in order to achieve exceptional outcomes. What you'll be DOING What will your essential responsibilities include? Proactively managing assigned professional liability claims across multiple lines of business, including initial analysis, drafting coverage letter, preparing a resolution strategy, and ensuring ongoing communication with stakeholders and claims management to achieve the best outcome for the client and AXA XL. Using robust technical skills, handle complex and difficult claims within authority level and specialization. Partnering with internal and external counsel in setting and pursuing effective and cost-efficient litigation strategies for claims in litigation, consistent with AXA XL litigation management best practices. Coordinating and managing communications with internal colleagues and key external stakeholders (e. g. , clients, brokers, reinsurers, vendors, etc. ), ensuring we are providing the highest level of customer service. Ensuring all documentation is present in the claim file and ensuring that Claims Handler Guidelines and protocols are followed. Managing expenses through thoughtful expense management and claims best practices. Assisting our underwriters with policy review and participating in external marketing and business development activities. Sharing lessons leaned and other identified trends to improve risk assessment and the underwriting process. Participating in the quality review procees and seeking to identify new and improved processes. Embracing short and long-term improvement initiatives. Producing internal reporting in support of best practices and reserving guidelines. Following the AXA XL Claim Alert process. Identifying, monitoring and reporting on emerging liability and coverage trends. Coaching less experienced colleagues and being a role model in best practices. You will report to Claims Manager, Hartford Professional. What you will BRING We're looking for someone who has these abilities and skills: Required Skills and Abilities: Education: Bachelor's degree required; Juris Doctor (JD) required. Experience: Professional liability claims-handling experience. Working knowledge of applicable regulations. Experience managing, negotiating and resolving high exposure and complex claims. Licensing: Insurance adjuster licenses for all states requiring licenses or willingness to immediately obtain such licenses upon starting. Proactive and Results Oriented File Handling: Ability to proactively manage assigned claims across multiple lines of the professional liability business. Approach tasks proactively and anticipate needs. Think quickly and prioritize multiple workstreams, while maintaining quality. Analytical and Technical Skills: Robust analytical and technical skills to handle complex and difficult claims. Sound judgment skills. Collaboration: Ability to collaborate with claims management on large and complex losses. Ability to develop and maintain productive working relationships with all colleagues, including insureds, brokers, claim handlers, underwriters and legal counsel. Willingess to seek input from others as needed to achieve the best result possible for the client and AXA XL. Communication: Excellent verbal and written communication, presentation and influencing skills. Ability to communicate effectively with internal and external stakeholders to make sure we provide the highest level of customer service. Ethics: Handle responsibilities with integrity and to the highest standards of professionalism. Continuous Improvement Focused: Willing to ask questions and explore new ideas. Eager to learn and ability to focus on continuously improving technical skills and AXA XL claims capabilities. Client-Service Oriented: Focus on value at all points in the claims experience, delivering on our promise to our clients. Who WE are AXA XL, the P&C and specialty risk division of AXA, is known for solving complex risks. For mid-sized companies, multinationals and even some inspirational individuals we don't just provide re/insurance, we reinvent it. How? By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business − property, casualty, professional, financial lines and specialty. With an innovative and flexible approach to risk solutions, we partner with those who move the world forward. Learn more at axaxl. com What we OFFER Inclusion AXA XL is committed to equal employment opportunity and will consider applicants regardless of gender, sexual orientation, age, ethnicity and origins, marital status, religion, disability, or any other protected characteristic. At AXA XL, we know that an inclusive culture and enables business growth and is critical to our success. That's why we have made a strategic commitment to attract, develop, advance and retain the most inclusive workforce possible, and create a culture where everyone can bring their full selves to work and reach their highest potential. It's about helping one another - and our business - to move forward and succeed. Five Business Resource Groups focused on gender, LGBTQ+, ethnicity and origins, disability and inclusion with 20 Chapters around the globe. Robust support for Flexible Working Arrangements Enhanced family-friendly leave benefits Named to the Diversity Best Practices Index Signatory to the UK Women in Finance Charter Learn more at Inclusion & Diversity at AXA XL | AXA XL. AXA XL is an Equal Opportunity Employer. Total Rewards AXA XL's Reward program is designed to take care of what matters most to you, covering the full picture of your health, wellbeing, lifestyle and financial security. It provides competitive compensation and personalized, inclusive benefits that evolve as you do. We're committed to rewarding your contribution for the long term, so you can be your best self today and look forward to the future with confidence. Sustainability At AXA XL, Sustainability is integral to our business strategy. In an ever-changing world, AXA XL protects what matters most for our clients and communities. We know that sustainability is at the root of a more resilient future. Our 2023-26 Sustainability strategy, called "Roots of resilience", focuses on protecting natural ecosystems, addressing climate change, and embedding sustainable practices across our operations. Our Pillars: Valuing nature: How we impact nature affects how nature impacts us. Resilient ecosystems - the foundation of a sustainable planet and society - are essential to our future. We're committed to protecting and restoring nature - from mangrove forests to the bees in our backyard - by increasing biodiversity awareness and inspiring clients and colleagues to put nature at the heart of their plans. Addressing climate change: The effects of a changing climate are far-reaching and significant. Unpredictable weather, increasing temperatures, and rising sea levels cause both social inequalities and environmental disruption. We're building a net zero strategy, developing insurance products and services, and mobilizing to advance thought leadership and investment in societal-led solutions. Integrating ESG: All companies have a role to play in building a more resilient future. Incorporating ESG considerations into our internal processes and practices builds resilience from the roots of our business. We're training our colleagues, engaging our external partners, and evolving our sustainability governance and reporting. AXA Hearts in Action: We have established volunteering and charitable giving programs to help colleagues support causes that matter most to them, known as AXA XL's "Hearts in Action" programs. These include our Matching Gifts program, Volunteering Leave, and our annual volunteering day - the Global Day of Giving. For more information, please see Sustainability at AXA XL. The U. S. base salary range for the Claims specialist position is 92,500-138,500 USD and for the Senior Claims Specialist is: 115,500-173,500 USD. Actual pay will be determined based upon the individual's skills, experience and location. We strive for market alignment and internal equity with our colleagues' pay. At AXA XL, we know how important physical, mental, and financial health are to our employees, which is why we are proud to offer benefits such as a competitive retirement savings plan, health and wellness programs, and many other benefits. We also believe in fostering our colleagues' development and offer a wide range of learning opportunities for colleagues to hone their professional skills and to position themselves for the next step of their careers. For more details about AXA XL's benefits offerings, please visit US Benefits at a Glance 2025.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: • Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim • The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions • Maintain claim block and meet departmental production and quality metrics • An awareness of industry claim practices • Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records • Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. • Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process • Establish cooperative and productive relationships with professional resources What you will bring with you: • Bachelor's degree preferred • A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing • Demonstrated ability to work as part of a cohesive team • Strong written and verbal communication skills • Knowledge of Stop Loss Claims and Stop Loss industry preferred • Demonstrated success in negotiation, persuasion, and solutions-based underwriting • Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism • Overall knowledge of health care industry • Proficiency using the Microsoft Office suite of products • Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/10/2025

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: • Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim • The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions • Maintain claim block and meet departmental production and quality metrics • An awareness of industry claim practices • Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records • Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. • Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process • Establish cooperative and productive relationships with professional resources What you will bring with you: • Bachelor's degree preferred • A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing • Demonstrated ability to work as part of a cohesive team • Strong written and verbal communication skills • Knowledge of Stop Loss Claims and Stop Loss industry preferred • Demonstrated success in negotiation, persuasion, and solutions-based underwriting • Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism • Overall knowledge of health care industry • Proficiency using the Microsoft Office suite of products • Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-AR1 #Li-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

Job Description The Insurance Claims Specialist will work closely with the VP of Risk Management mitigating risks, promoting a safe environment for both residents and staff, supporting operational risk initiatives, and safeguarding company resources. This role is integral to supporting the financial health of the organization by collaborating closely with the finance team ensuring accurate invoicing, providing actionable data analysis, ensuring compliance and optimizing claims outcomes. DUTIES AND KEY RESPONSIBILITIES: Claims Management and Oversight Manage and oversee workers' compensation, EPLI, GL, and PL claims from initial reporting through resolution. Respond to inquiries and concerns regarding new and existing claims Conduct timely and thorough investigations, coordinating with internal and external stakeholders, requesting/reviewing witness statements, video footage etc. and ensure all claims are accurately documented and supported. Collaborate with claim and broker partners, build and maintain strong relationships to ensure effective claims handling and dispute resolution. Maintain clear, consistent communication with Vice President of Risk Management, various team members, business partners, and other stakeholders regarding claims handling and their resolutions. Compliance and Reporting Ensure all claims processes adhere to state regulations and company policies, maintaining compliance with industry standards. Prepare and maintain regular reports on claims status, costs, and outcomes for internal review and regulatory purposes. Monitor claim trends and identify risk mitigation opportunities. Financial Coordination and Invoicing Coordinate with the finance team to ensure accurate claims invoicing, payment tracking, and budgeting. Support the finance team with forecasting and financial planning related to insurance claims and associated expenses. Work with finance team to place and monitor appropriate reserves and allocate funds. Data Analytics and Reporting Analyze claims data to provide insights into claim trends, financial impact, and risk management strategies. Develop and maintain dashboards and reporting tools to communicate claims data with key stakeholders. Use data insights to recommend and implement improvements to claims processes and cost-saving initiatives. Collaboration and Communication Work closely with VP of Risk Management, finance, HR, and community leadership teams to streamline claims processing and minimize organizational risk. Serve as a primary point of contact for insurance carriers, third-party administrators, and internal teams on claims-related matters. Provide regular updates to management on claims status, strategic initiatives, and risk trends. Educate team members and on-site staff about claim reporting procedures, documentation best practices, and risk mitigation strategies. Assist in training sessions on safety and risk prevention, fostering a culture of proactive incident management. QUALIFICATIONS: 3-5 years of experience in insurance claims management, preferably within the healthcare or assisted living industry. Associate's degree required. Excellent customer service skills Strong analytical and problem-solving skills to investigate and diagnose claim driven issues Aptitude to investigate complaints for facts and recommend resolutions in a timely manner Exceptional interpersonal, verbal, and written communication skills Proven customer relationship and conflict resolution skills Ability to develop and maintain strong working relationships with internal and external parties Strong attention to detail and accuracy in data entry and record keeping Must be willing to travel to various community locations for meetings, investigations, and internal audits as required.

About Us We're not like other insurance companies. From our specialty products to our business model, our culture to our results - we're different. Different is who we are, and how we work, interact, deliver and succeed together. Creating a different and better insurance experience doesn't just happen. It takes focus and a shared passion for going beyond the expected to forge relationships and deliver care that makes a difference. This approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Apply today to make a difference with us. RLI is a Glassdoor Best Places to Work company with a strong, successful background. For decades, our financial track record has been stellar - a testament to our culture and validation of our reputation as an excellent underwriting company. Principal Duties & Responsibilities * Proactively handle Personal Umbrella Liability claims (auto, premises and personal liability) with a detailed focus on claim investigation, evaluation, and monitoring of primary carrier activity to achieve optimum results. * Effectively investigate and analyze complex coverage issues and write coverage letters as appropriate. * Complete timely and thorough investigations into liability and damages for early exposure recognition. * Focus on claims resolution with timely and effective liability investigations and damage evaluations and reserve setting. * Handle claims in accordance with RLI's Best Practices. Education & Experience * Typically requires a bachelor's degree and 6+ years of relevant legal or technical claims experience. * Experience handling large exposure third-party liability claims on a primary/excess basis is preferable. * Significant experience in effective handling of policy limit demands in states such as Florida, Texas and California. * Must be able to excel in a fast-paced environment with little supervision. * Effectively work with primary carriers and defense counsel and understand umbrella/excess handling and management of outside counsel. * Ideal candidate will have superior working knowledge of Florida, California, New York and Texas case law, statutes and procedures impacting the handling and value of liability claims. Knowledge, Skills, & Competencies * Ability to use analytical methods in complex claim processes to find workable solutions. * Ability to generate innovative solutions within the claims department. * Ability to communicate findings and recommendations to internal and external contacts on claim matters. Compensation Overview The base salary range for the position is listed below. Please note that the base salary is only one component of our robust total rewards package at RLI. The salary offered will take into account a number of factors including, but not limited to, geographic location, experience, scope & responsibilities of the role, qualifications/credentials, talent availability & specialization, as well as business needs. The below range may be modified in the future. Base Pay Range $108,348.00 - $157,917.00 Total Rewards At RLI, we're all owners. We hire the best and the brightest employees and allow them to share in the company's success through our Total Rewards. With the Employee Stock Ownership plan at its core, the Total Rewards program includes all compensation, benefits and perks that come with being an RLI employee. Financial Incentives * Annual bonus plans * Employee stock ownership plan (ESOP) * 401(k) - automatic 3% company contribution * Annual 401k and ESOP profit-sharing contributions (Up to 15% of eligible earnings) Work & Life * Paid time off (PTO) and holidays * Paid volunteer time off (VTO) to support our communities * Parental and family care leave * Flexible & hybrid work arrangements * Fitness center discounts and free virtual fitness platform * Employee assistance program Health & Wellness * Comprehensive medical, dental and vision benefits * Flexible spending and health savings accounts * 2x base salary for group life and AD&D insurance * Voluntary life, critical illness, & accident insurance for purchase * Short-term and long-term disability benefits Personal & Professional Growth RLI encourages its employees to pursue professional development work in insurance and job-related areas. We make a commitment to employees to provide educational opportunities that help them enhance their skills and further their career advancement. RLI fosters a true learning culture and encourages professional growth through insurance courses, in-house training and other educational programs. RLI covers the cost for most programs and employees typically earn a bonus upon successful completion of approved courses and certifications. Our personal and professional growth benefits include: * Training & certification opportunities * Tuition reimbursement * Education bonuses Diversity & Inclusion Our goal is to attract, develop and retain the best employee talent from diverse backgrounds while promoting an environment where all viewpoints are valued and individuals feel respected, are treated fairly, and have an opportunity to excel in their chosen careers. We actively support, and participate in, initiatives led by the American Property Casualty Insurance Association that aim to increase diversity in the insurance industry. Cultivating an exceptional and diverse workforce to deliver excellent customer service reinforces our culture and is a key to achieving superior business results. RLI is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law.

Job Description The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice Ability to identify, analyze and solve problems Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to meet or exceed performance competencies Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Minimum of 1 year of industry experience and claims management preferred State Certification as an Experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our must-haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary range $140,000 - $155,000 (Boston, Manhattan, West Hartford) Salary range $125,000-$135,000 (Chicago, Atlanta) The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-AJ1 Work with amazing people and be part of a unique culture

Claims Representative - CH09CNAssociate Claim Representative - CH10DN We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future. As a General Liability Associate Claims Representative for all business lines, you're at the front lines for our customer. Your primary role is to investigate and manage claim files to help individuals and businesses prevail after a claim. The Hartford will provide you with a robust training and onboarding program, as well as ongoing coaching and development to ensure your success. Start Date: February 16, 2026 Hours: 8am-5pm, Core Business hours to support either our Eastern or Western region, limited flexibility. Virtual Training: 8 weeks, core business hours, your local time This role will have a Hybrid work arrangement, with the expectation of working in an office location : (Hartford, CT / San Antonio, TX / Aurora (Naperville) IL/ Lake Mary, FL/ Scottsdale, AZ ) 3 days a week (Tuesday through Thursday). Responsibilities: + Utilize active listening and critical thinking skills to quickly analyze customer needs + Leverage knowledge and resources to provide the appropriate solutions to requests + Take ownership to ensure that we go above and beyond in providing customer service + Utilize every touch point as an opportunity to build value and The Hartford brand + Commit to learning and developing + Develop an in depth understanding of Hartford products and business lines + Act as a liaison with other departments to resolve problems + Secure essential facts about losses + Negotiate settlements + Interpret, understand and explain coverage to policyholders + Efficiently update and move files to closure + Manage pending claims to meet company quality criteria + Ensure payments are processed timely as needed or input payments within authority + Special assignments or projects as assigned + May be required to assist in catastrophe situations + Develop proficiency and capabilities expected during new hire ramp-up period + Must demonstrate strong customer service focus + Ability to operate, lead and coach within The Hartford Way management system Qualifications: + High School Diploma required; college degree preferred + Minimum of 1 year of related customer service experience or applicable insurance experience + Excellent oral, written and interpersonal communication + Demonstrated capacity to multi-task in a structured work environment + Ability to utilize multiple systems to handle/process claims + Problem solving and critical thinking skills are a must + Strong attention to detail Additional Information: + As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance Claims in the states supported by your office. Continued employment with The Hartford is contingent upon the successful passage of the Licensing exam(s) within 30 business days from the completion of the licensing training. Compensation The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford's total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is: $45,280 - $79,320 The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience. Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age About Us (************************************* | Our Culture (******************************************************* | What It's Like to Work Here (************************************************** | Perks & Benefits (********************************************* Every day, a day to do right. Showing up for people isn't just what we do. It's who we are - and have been for more than 200 years. We're devoted to finding innovative ways to serve our customers, communities and employees-continually asking ourselves what more we can do. Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable? That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined. And while how we contribute looks different for each of us, it's these values that drive all of us to do more and to do better every day. About Us (************************************* Our Culture What It's Like to Work Here (************************************************** Perks & Benefits Legal Notice (***************************************** Accessibility Statement Producer Compensation (************************************************** EEO Privacy Policy (************************************************** California Privacy Policy Your California Privacy Choices (****************************************************** International Privacy Policy Canadian Privacy Policy (**************************************************** Unincorporated Areas of LA County, CA (Applicant Information) MA Applicant Notice (******************************************** Hartford India Prospective Personnel Privacy Notice

The GT Self Determination Claims Specialist maintains a core understanding of the company and of Operations. The GT Self Determination Claims Specialist is expected to follow departmental procedures and adhere to GT and agency guidelines to ensure work is completed accurately and efficiently. The GT Self Determination Claims Specialist maintains knowledge, skills, and abilities that contribute to various accounting/administrative tasks involved in preparing billing data for agencies in which GT Independence holds a contract. All GT Self Determination Claims Specialists must maintain a core understanding of the company and of Operations. RESPONSIBILITIES AND DUTIES · Preparation of billing data to be used in the billing of payers · Responsible for complying with contractual provisions with each agency regarding the submission of billing and encounter data, including the related monthly reports · Submit invoices to agencies · Applies payments · Collects on unpaid claims · Prepares advance reconciliations and applies payments to the general ledger · Enters information into computer databases for effective record keeping · Collaborates with other staff members to optimize delivery of services · Ensures all compliance standards are met for audit purposes · Maintains confidentiality of records relating to clients · Identifies opportunities to improve our processes · Upholds company values and mission · Other duties as assigned EDUCATION High School Diploma or GED required Associate degree preferred EXPERIENCE AND QUALIFICATIONS · 2 years of experience relevant to the work performed · Experience with Microsoft Office products is necessary, specifically Microsoft Excel · Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, designing forms, and other office procedures and terminology · Excellent written and oral communication skills · Ability to plan and organize daily work to meet strict deadlines · Strong attention to detail · Able to work with numbers and apply basic math skills to daily tasks · Strong ability to participate on a highly effective team WORK ENVIRONMENT Work is performed in a typical office setting or from a home office.

Chubb is currently seeking a Workers' Compensation Claim Representative for our Northeast, New York, and New Jersey Region. The successful applicant will be handling claims from Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, and New Jersey. The position will report to, and reside in, our New Haven, Connecticut, office. Duties & Responsibilities: Handles all aspects of workers' compensation medical only claims from set-up to case closure, ensuring strong customer relations are maintained throughout the process. Reviews claim and policy information to provide background for the investigation. Conducts three-part ongoing investigations, obtaining facts and taking statements as necessary, with the insured, claimant, and medical providers. Evaluates the facts gathered through the investigation to determine the compensability of the medical treatment. Informs insureds and claimants of claim denials when applicable. Prepares reports on investigations, settlements, denials of claims, evaluations of involved parties, etc. Timely administration of statutory medical only benefits throughout the life of the claim. Sets reserves within authority limits for medical and expenses and recommends reserve changes to Team Leader throughout the life of the claim. Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them. Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered. Controls and directs vendors, nurse case managers, and telephonic case managers on medical management. Complies with customer service requests, including Special Claims Handling procedures and file status notes. Submits workers' compensation forms and electronic data to states to ensure compliance with statutory regulations. Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized. Works with in-house Technical Assistants, Special Investigators, Nurse Consultants, Telephonic Case Managers and Team Supervisors to exceed customers' expectations for exceptional claim handling service. Technical Skills & Competencies: Entry-level Medical Only Claim Examiner position. Knowledge of insurance, claims, and workers' compensation statutes, regulations, and compliance is a plus, but on-the-job training will be provided to the chosen applicant. Ability to incorporate data analytics and modeling into daily activities to expedite the fair and equitable resolution of claims and claim issues. A personal commitment to superior performance that adds value to our company and our customers. Ability to work effectively with a wide variety of people. An aptitude for evaluating, analyzing, and interpreting information. Superior telephonic skills. Excellent organizational skills. The ability to multi-task with proven time management skills to meet deadlines. Ability to work well in teams. Demonstrate critical thinking and decision-making ability. Excellent verbal and written communication skills. Experience, Education, & Requirements: Prior medical only or similar claim handling experience is a plus but not required. Proficiency in using Microsoft Office Products Experience in a fast-paced, fluid environment Strong communication and telephonic skills Knowledge of medical terminology is a plus but not required. Knowledge of bill processing is a plus but not required. If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.

Dated: 06/09/2021 JOB DESCRIPTION Intake/Certification Specialist (898A) DEPARTMENT: Energy FLSA STATUS: Non-Exempt REPORTS TO: Assistant Program Manager Energy Services The purpose of this position is to support the Agency's needs by scheduling customer appointments, conducting customer intake and performing tasks necessary to ascertain customer eligibility per program guidelines. Based on CRT's Steps to Success service delivery model, the Intake/Certification Specialist also provides customers with application assistance for and referrals to agency and community resources. SPECIFIC DUTIES AND RESPONSIBILITIES ESSENTIAL JOB FUNCTIONS The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. It is not necessarily descriptive of any one position in the class. The omission of an essential function does not preclude management from assigning duties not listed herein if such functions are a logical assignment to the position. Responds to all emergency cases within 24 hours of customer inquiry. Responsible for responding to all non-emergency customer inquiry as stipulated in program guidelines. Schedules and reschedules customer intake appointments, as needed. Provides quality customer service. As assigned, conducts customer intake and reviews customer application and accompanying documentation for accuracy and completeness and to ensure service eligibility as outlined in program rules and regulations. Maintains orderly customer paper files in accordance with program requirements Demonstrates proficiency in the use of available technology to maintain accurate computer-based files in accordance with agency and program requirements. Refers customers to internal and external resources in support of comprehensive attention to customer need. Processes energy applications using DSS procedural instructions. Process energy applications per CRT's Quality Assurance procedures. Prepares program reports in accordance with program requirements and agency need. Possesses excellent oral and written communication skills that demonstrate the ability to communicate with persons of varying racial/ethnic and socio-economic cultures. Attends courses, professional workshops/training, seminars and/or participates in self-directed studying that will provide for continuous professional growth related to this position. Obtains/maintains valid certifications to sharpen and refresh job skills. Performs outreach services and participates in community events and/or conducts community education sessions. Maintains daily activity log. ADDITIONAL JOB FUNCTIONS Responds to supervisor, upper management and program funder requests for information as requested. Some in-state travel may be required. Performs all other duties as assigned. MINIMUM TRAINING ANDEXPERIENCE Education: Associate's Degree in human services or related field from an accredited two year college or university preferred. A high school diploma and work experience may be substituted for a college degree. Demonstrated Skills: The ability to manage time in a fast-paced environment and accomplish job responsibilities under minimum supervision. Experience with non-profit or community volunteering. Must have strong listening, oral and written communication skills. Bilingual: English/Spanish preferred. Driving Required: Preferred Agency Vehicle: No Employee's Own Vehicle: Preferred ADA COMPLIANCE Physical Ability: Tasks involve the ability to exert very moderate physical effort in light work, typically involving some combination of stooping, kneeling, crouching and crawling, and which may involve some lifting, carrying, pushing and/or pulling of objects and materials of moderate weight (12-20 pounds). Sensory Requirements: Some tasks require visual perception and discrimination. Some tasks require oral communications ability. Environmental Factors: Tasks are regularly performed without exposure to adverse environmental conditions, such as dirt, dust, pollen, odors, wetness, humidity, rain, fumes, temperature and noise extremes, machinery, vibrations, electric currents, traffic hazards, animals/wildlife, toxic/poisonous agents, violence, disease, or pathogenic substances. Acknowledgment Signature indicates agreement with contents herein as being an accurate description of position duties and responsibilities. _____________________________________ EMPLOYEE PRINTED NAME _____________________________________ ____________________ EMPLOYEE SIGNATURE DATE Signature indicates agreement with contents herein as being an accurate description of position duties and responsibilities. _____________________________________ IMMEDIATE SUPERVISOR PRINTED NAME _____________________________________ ____________________ IMMEDIATE SUPERVISOR SIGNATURE DATE Community Renewal Team, Inc. is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, Community Renewal Team will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer. Monday-Thursday 9a-5p with a Saturday from 8am - 4pm at 395 Wethersfield Ave Hartford, CT.

Job Category: Administrative & Clerical Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. Under the supervision of the Utilization Review Manager, this position is responsible for ensuring the delivery of outstanding customer service in the process of obtaining pre-certification approvals from insurance companies (for both inpatients and outpatients), identifying insurance and/or patient responsibility, insurance verification, admission notifications, identifying approved days, follow up required, and providing financial counseling when appropriate. Minimum Job Qualifications Licensure or other certifications: AAPC or AHIMA certification accepted Educational Requirements: High School Diploma or GED Minimum Experience: Other: Preferred Job Qualifications Preferred Licensure or other certifications: CPC Certification Preferred Educational Requirements: Preferred Experience: One (1) year of direct pre-certification experience preferred with CPC certification. Other: Knowledge, Skills and Abilities Ability to work independently, emotionally mature, and able to function effectively under stress Excellent problem solving and analytical skills Excellent written and oral communication skills Ability to prioritize, organize, and coordinate daily work load Working knowledge of Protected Health Information Ability to manage change Extensive knowledge of medical terminology Must possess detailed understanding and knowledge of insurance guideline and protocols, the components of full verification, and payer information / requirements Essential Tasks and Responsibilities Responsible for ensuring all scheduled and non-scheduled inpatient and outpatient accounts are pre-authorized either in advance or on the day of the notification of admission (following guidelines set forth by the organization and payers). Provides and interprets clinical information submitted from the Physician, emphasizing the medical justification for a procedure, in order for completion of the pre-certification process. Works in conjunction with Physician offices, Case Management, Utilization Review, and patients to obtain supporting clinical data for the payer in order to obtain a pre-authorization. Obtains complete and accurate insurance information and completes verification of the patient's eligibility for both inpatient and outpatient hospital visits. Acts as liaison and point of contact for/between clinical staff, ancillary departments, patients, referring Physician's office, and insurance payers to inform of authorization delays/denials. Collaborates with Utilization Review nurses to ensure authorization for services is obtained and fully documented in the patient account. Ensures thorough documentation in the patient account of verification and authorization activities. Communicates with Physician office and payer to initiate and mediate Physician to Physician reviews. Understands and retains knowledge of payer requirements in relation to procedure vs. plan type and demonstrates the ability to make informed decisions as to when a pre-authorization is needed. Responsible for the accurate and timely documentation of the pre-certification into the appropriate account. Collaborates with the appeals department to provide all related information to overturn denied claims. Helps monitor insurance authorization issues to identify trends and participates in process improvement initiatives. Expected to answer, manage, and satisfy the customer during all incoming calls as appropriate to their specialty, and to meet department assigned goals relating to outbound calls, average speed to answer, max delays, AUX times, abandonment rate, and ACD time. In addition, expected to meet all customer service standards as set forth by the NGHS STARS standards. Performs any and all related job duties as assigned; may have additional department specific duties assigned as deemed necessary by management. Expected to meet all goals set by department management to include, but not limited to; productivity, accuracy, collections, and customer satisfaction. Physical Demands Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time Weight Carried: Up to 20 lbs, Occasionally 0-30% of time Vision: Moderate, Constantly 66-100% of time Kneeling/Stooping/Bending: Occasionally 0-30% Standing/Walking: Occasionally 0-30% Pushing/Pulling: Occasionally 0-30% Intensity of Work: Occasionally 0-30% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is Seeking a Commercial Lines Claims Specialist to join our growing team in Somers, NY. Part-Time Claims position. Accept and oversee all types of Commercial Auto Claims for accounts assigned. Assist in servicing consulting contracts. Provide prompt, accurate and courteous claim service to the Agency's customers, both internal and external. How You Will Contribute * Acceptance of claims, making assignments to companies and/or independent services. * Research coverage, leases and contracts and participate in discussions with Account Mangers and producers regarding same. * Reading, analyzing, and processing of litigation paperwork. * Reserve monitoring and communication with Companies regarding evaluation of same. * Ongoing assistance in claims management of company claims. * Maintain diary system relating to first party losses, claims in subrogation, and Select Top 100 losses. * Completion of reports and suit activities as department policy dictates. * Assist underwriting staff with claim information relating to policies qualifying for experience rating and/or workers' compensation dividend plans. * Complete monthly report to clients which includes loss run and tracking of the physical damage claims. * Complete monthly billing to clients for services. * Preparation of claims management reports and experience modification reports as required by account size. Skills & Experience to Be Successful * Minimum of two years college required. * Two to four years claims adjusting experience, preferably commercial lines involving both first- and third-party claims. * Arbitration forums participation * Valid Driver's license. * This position requires routine or periodic travel which may require the teammate to drive their own vehicle or a rental vehicle. Acceptable results of a Motor Vehicle Record report at the time of hire and periodically thereafter, and maintenance of minimum acceptable insurance coverages are a requirement of this position. * College degree.(preferred) #LI-DA1 Pay Range $30.00 - $39.00 Hourly The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: * Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance * Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement * Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services * Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, "The Power to Be Yourself".

approved under NYS HELP Program. The NYS Civil Service Commission approved these titles as part of the "HELP" program. Approval is for a period of one year effective 5/24/2023. During this period, employees may be appointed on a non-competitive basis. All non-competitive appointees must meet the minimum qualifications for the positions. Applications will be reviewed and approved by Civil Service. *Candidates will not be required to take traditional civil service exams to attain permanent positions. JOB DESCRIPTION: Review, investigate, evaluate documents and determine eligibility of applications for Temporary Assistance and programs such as SNAP, Medicaid, Child Care and HEAP; Interview applicants and recipients and, as needed, collateral contacts for documentation of eligibility; Evaluates and determines applicant's eligibility for assistance based on an assessment of resources and indicated or identified needs. Prepares and computes budget for the applicants. Advises applicant of his/her rights and responsibilities under the Social Services Law, and makes referrals to other Social Services where need is indicated and/or identified. ** These duties may be performed at one of the Social Services office locations: Hauppauge, Deer Park, Ronkonkoma, Coram or Riverhead** Starting Salary: $41,525 MINIMUM QUALIFICATIONS OPEN COMPETITIVE EITHER: a) Graduation from a standard senior high school or possession of a high school equivalency diploma, and two (2) years of experience in examining, investigating or evaluating claims for assistance, veterans' or unemployment benefits, insurance or a similar program operating under established criteria for eligibility; or , b) Graduation from a standard senior high school or possession of a high school equivalency diploma and two (2) years of experience in a NYS public social services agency performing duties that require substantial client contact for the purpose of implementing, assessing or directly providing agency programs and services. NOTE : Additional education from a college with federally-authorized accreditation or registration by NY State will be substituted for experience on a year-for-year basis. NECESSARY SPECIAL REQUIREMENT(S) At the time of appointment and during employment in this title, employees will be required to possess a valid license to operate a motor vehicle in New York State. For the spanish speaking role ONLY, there will be a qualifying Spanish language examination for Open-Competitive candidates. Suffolk County's Commitment to Diversity, Inclusion & Equity: Our focus is to promote, support, and implement the County-wide diversity and inclusion strategic plan. We achieve results in all our responsibilities through the use of diversity and inclusion best practices. We maintain a familiarity with Diversity & Inclusion trends and best practices. Suffolk County is an Equal Employment Opportunity Employer and does not discriminate against applicants or employees on the basis of race, color, religion, creed, national origin, ancestry, disability that can be reasonably accommodated without undue hardship, sex, sexual orientation, gender identity, age, citizenship, marital or veteran status, or any other legally protected status.

Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business. * This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change. Responsibilities * Analyzes, investigates and evaluates the loss to determine coverage and claim disposition. * Utilizes proprietary claims management system to document claims and to diary future events or follow up. * Issue detailed coverage position letters for all new claims within prescribed time frames. * Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level. * Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting. * Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment. * Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority. * Participates in the claims audit process. * Provides claims marketing services by meeting with brokers and insureds. * As required, maintains insurance adjuster licenses Qualifications * Bachelors' and/or advanced degree * 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers) * Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge * Functional knowledge of law and insurance regulations in various jurisdictions * Demonstrated advanced verbal and written communications skills * Demonstrated advanced analytical, decision making and negotiation skills About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco