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Claim Processor Jobs in Lansdale, PA

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  • Claims Specialist I-Property

    Everest Group Ltd. 3.8company rating

    Claim Processor Job 18 miles from Lansdale

    About Everest Everest Group, Ltd. (Everest), is a leading global reinsurance and insurance provider, operating for nearly 50 years through subsidiaries in North America, Latin America, the UK & Ireland, Continental Europe and Asia Pacific regions. Throughout our history, Everest has maintained its discipline and focuses on creating long-term value through underwriting excellence and strong risk and capital management. Our strengths include extensive product and distribution capabilities, a strong balance sheet, and an innovative culture. Our most critical asset is our people. We offer dynamic training & professional development to our employees. We also offer generous tuition/continuing education reimbursement programs, mentoring opportunities, flexible work arrangements, and Colleague Resource Groups. The Claims Team at Everest Insurance, a member of the Everest Re Group, is looking for an experienced Commercial Property Claims Specialist to join our Property and Inland Marine Claims team. The preferred location is Warren, NJ but would consider other locations based upon experience. Responsibilities include but not limited to: * Experience handling Commercial Property and/or Builders Risk Claims. * Strong knowledge of Property Forms and Endorsements. * Ability to manage Independent Adjusters. * Ability to review and analyze property damage estimates. * Review and analyze coverage and prepare appropriate coverage position letters. * Investigation, analysis, and evaluation of assigned claims to determine exposure. * Management and direction of outside counsel as well as reviewing and approving legal and/or expense budgets and bills. * Preparation of case summary reports related to matters of significant reserve activity. * Timely and appropriate setting of claim reserves. * Development and execution of claim strategies as well as resolution strategies. * Negotiation and resolution of claims. * Determine and resolve workload and assignment issues to ensure effective claims processing, expense management and claims disposition. * Attend trials and mediations. * Vendor oversight and management, including auditing of same. * Identify issues and trends in the portfolio; take appropriate and/or corrective action where necessary; communicate trends to underwriters, insureds, and brokers. * Extensive communication with insureds, brokers, reinsurers, actuaries, and business unit contacts. * Attend client meetings and industry functions to support retention and development of client relationships and business. Qualifications, Education & Experience: * The ideal candidate will have 5+ years of Commercial Property claims experience and current, working knowledge of jurisdictional laws and regulations. * Bachelor's degree or equivalent work experience required. * Insurance industry designation(s)/certification(s) preferred. Knowledge, Skills & Competencies: * Strong oral and written communication skills. * Strong analytical and organizational skills. * Strong negotiation and investigation skills. * Excellent interpersonal skills. * Ability to evaluate coverage issues involving a wide variety of loss scenarios. * Ability to think strategically. * Currently holds or readily can obtain all required adjuster licenses. * Knowledge of the insurance industry, claims and the insurance legal and regulatory environment. * Knowledge of claims handling or insurance legal statutes and procedures. * Ability to identify and use relevant data and metrics to best manage claims. * Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency. * Ability to and willingness to present to senior management and other group settings. * Ability to influence others and resolve complex, disputed claims * Some travel required. Our Culture At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture. * Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion. * Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together. All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve. For NY Only: The base salary range for this position is $80,000 - $140,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location. #LI-Hybrid #LI-VP1 Type: Regular Time Type: Full time Primary Location: Warren, NJ Additional Locations: Atlanta, GA, Boston, MA, Hartford, CT, New York, NY, Philadelphia, PA Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at *********************************. Everest U.S. Privacy Notice | Everest (everestglobal.com)
    $80k-140k yearly Easy Apply 16d ago
  • Claims Examiner Trainee (Wayne, PA)

    ICW Group 4.8company rating

    Claim Processor Job 18 miles from Lansdale

    Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for seven consecutive years as a Top 50 performing P&C company offering the stability of a large, profitable and growing company combined with a small-company entrepreneurial spirit. Our purpose-driven ethos provides team members with opportunities to contribute, develop, and belong. ICW Group's Claims Academy Examiner Training Program prepares aspiring professionals for a career as a Claims Examiner in the Worker's Compensation Industry. We are seeking energetic, customer focused individuals with a passionate desire to help others and who are looking to begin an exciting new career. Trainees will go through a Workers' Compensation Claims Examiner Training Program. Upon successful completion, they will move into a Claims Examiner Role where they will be managing claims and providing benefits to injured workers. The program start date is 4/21/2025 PURPOSE OF THE JOB The purpose of this job is to learn how to administer benefits to injured workers in accordance with the Labor Code. It exists to learn how to maintain and handle Worker's Compensation Claims within the Company standards and best practices guidelines. ESSENTIAL DUTIES AND RESPONSIBILITIES Learns how to investigate and gather necessary information to process and settle claims. * Develops skills to be able to communicate with insureds to obtain information necessary for processing claims. Contacts and/or interviews injured workers, medical specialists or employers to obtain necessary information to manage a claim. * Develops skills to be able to assist legal counsel to ensure timely and cost-effective litigation. Gains an understanding of when to refer to legal counsel. * Develops skills to be able to pursue subrogation, recoveries and contributions vigorously and within statutory timeframes. Gains technical knowledge to ensure the fair and prompt management of cases. * Develops the skills to be able to present cases and participates in their discussion at claim committee meetings. * Develops the skills to be able to create and adjust reserves in a timely manner to ensure reserving activities are consistent with company policies. * Develops the skills to be able to manage and approve payment of benefits within the designated authority level. Assists in the operational and administrative duties for the Claims department. * Develops the skills to administer benefits to injured workers. * Learns to ensure accuracy of data in claims system for compliance with applicable regulatory reporting. * Understands how to ensure appropriate referral to preferred vendor partners to comply with cost containment procedures to reduce overall claim cost. Reviews and understands the medical aspects of claims management. * Develops knowledge of medical terminology. * Learns the various types of diagnostic studies and how they are utilized. * Gains an understanding of the AMA guides and how to apply this knowledge. SUPERVISORY RESPONSIBILITIES This role does not have supervisory responsibilities. EDUCATION AND EXPERIENCE * High School diploma or general education degree (GED) required. * Bachelor's degree from a four-year college or university preferred. CERTIFICATES, LICENSES, REGISTRATIONS * All examiners must receive certification that meets the minimum standards of training, experience and skill. * State Worker's Compensation license is required in some branches. KNOWLEDGE AND SKILLS * Excellent verbal and written communication skills, time management and organizational skills. * Requires a high level of attention to detail. * Must have a sense of urgency for execution. PHYSICAL REQUIREMENTS Office environment - no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear. WORK ENVIRONMENT This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment. The compensation for this role is a progressive structure over a one-year period based on predetermined qualifications and goals being achieved: Stage/Salary Start.......................................$31.15 Initial Increase.......................$34.27 Stage 1 Completion*.............$35.29 Stage 2 Completion*.............$36.70 Stage 3 Completion*.............$38.54 * Salary will be reviewed at completion date of each stage upon conclusion of claim file audit by reporting Supervisor/Manager and/or Audit & Compliance team confirming the outlined success measures/KPI have been met. We are currently not offering employment sponsorship for this opportunity #LI-ET1 #LI-Hybrid The current range for this position is $29.80 - $46.99 This range is exclusive of fringe benefits and potential bonuses. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work. WHY JOIN ICW GROUP? * Challenging work and the ability to make a difference * You will have a voice and feel a sense of belonging * We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match * Bonus potential for all positions * Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per year) * 11 paid holidays throughout the calendar year * Want to continue learning? We'll support you 100% ICW Group is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. ICW Group will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.
    $62k-85k yearly est. 2d ago
  • Multi-Line Claims Examiner

    Berkley 4.3company rating

    Claim Processor Job 26 miles from Lansdale

    Company Details What makes Admiral Insurance Group ADMIRABLE . Since 1974, Admiral Insurance Group has been supporting business innovation and market growth through our wholesale-dedicated excess and surplus (E&S) lines of commercial insurance. We specialize in underwriting difficult-to-place moderate to high-risk commercial businesses that require creative solutions, outside of the box thinking, entrepreneurial spirit and astute business knowledge. As a member of the W. R. Berkley Corporation, a Fortune 500 Company and one of the nation's premier commercial lines property casualty insurance providers, we have the resources, support and industry data to provide exceptional service and exciting solutions for our clients and partners. Unlock your insure -ability. Learn more about Careers at Admiral Insurance Group. See what it's like to work in Admiral's Claims department. The Company is an equal employment opportunity employer. Responsibilities The Multi-Line Claims Examiner is responsible for determining and discharging the company's contractual obligations under its various policy contracts involving coverage analysis, investigation, legal defense, and loss and expense reserving. Incorporate all claims into company records and review for applicability of coverage. Conference coverage questions, reserves, and settlement authority with Manager and Claims Committee pursuant to best practices, including preparation of large loss reports. Present facts of claims, with recommendations, to committee as necessary. Establish initial loss and expense reserves. Maintain valid loss and expense reserves based on current investigation and legal discovery. Provide ongoing direction to adjusters, investigators and defense attorneys to ensure that all claims are adequately handled. Attend and participate in mediations and trials as necessary with supervision. Adhere to company procedures and guidelines as well as case law and statutory requirements when coverage is in question, and/or when paying or denying claims. Review trade journals, Unfair Claim Practice Acts, etc. to ensure current understanding as they relate to the specified job duties. Review incoming billing statements for accuracy and process for payment. Attend industry related seminar workshops and/or courses for continuing education. Additional tasks as assigned. Qualifications Bachelor's Degree preferred (or equivalent work experience). Minimum of three years of progressive commercial insurance claims handling experience. Ability to assess priorities and manage deadlines effectively. Effective communication skills, both verbal and written. Strong research and analytical skills. Must have strong problem-solving skills and excellent organization skills. Must be customer service oriented. Up to 20% travel. Proficiency with MS Office Suite. Additional Company Details We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. 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. Sponsorship Details Sponsorship not Offered for this Role
    $70k-101k yearly est. 60d+ ago
  • LTD Claims Examiner II

    Reliance Standard Life Insurance Company

    Claim Processor Job 18 miles from Lansdale

    Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy. Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line. Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner. Conducts in-depth pre-existing condition or contestable investigations if applicable. Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, etc. Develops and maintains on-line claim data (and paper file if applicable). Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands. Analysis and Adjudication Fully investigates and adjudicates a large volume simple to complex claims. Identifies and investigates change in Total Disability definition (any occ). Independently reviews and manage claims with high degree of complexity within the $1,500 per month approval authority limit. Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium. Majority of work is not subject to supervisor review and approval. Case Management Consistently manage assigned case load of 60-80 simple to complex cases independently. Collaborates with team members and management in identifying and implementing improvement opportunities. REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE *or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience* Required Knowledge, Skills, Abilities and/or Related Experience High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred. 2 years experience processing long term disability claims. Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation. Experience working in confidential/protected identification environments. Knowledge of medical terminology. Good math and calculation skills. Proven ability to work well in a high-visibility, public-oriented environment. Ability to Travel: None PHYSICAL REQUIREMENTS When used in the description below, the following terms are defined as: “Occasional”: done only from time to time, but necessary when it is performed “Frequent”: regularly performed; generally an act that is required on a daily basis “Continuous”: typically performed for the majority of an employee's shift Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law. CORE VALUES Collaboration Compassion Empowerment Integrity Fun The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job. The expected hiring range for this position is $54,990.00 - $68,750.00 annually for work performed in the primary location (Philadelphia, PA). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that creating a more diverse, equitable and inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: An annual performance bonus for all team members Generous 401(k) company match that is immediately vested A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account Multiple options for dental and vision coverage Company provided Life & Disability Insurance to ensure financial protection when you need it most Family friendly benefits including Paid Parental Leave & Adoption Assistance Hybrid work arrangements for eligible roles Tuition Reimbursement and Continuing Professional Education Paid Time Off, volunteer days, community partnerships, and Employee Assistance Program Ability to connect with colleagues around the country through our Employee Resource Group program and our Diversity Equity & Inclusion Council Our Values: Integrity Empowerment Compassion Collaboration Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Remote #LI-MR1
    $55k-68.8k yearly 15d ago
  • Claim Examiner

    A-G Specialty Insurance, LLC

    Claim Processor Job 15 miles from Lansdale

    The Claim Examiner is responsible for managing, investigating, and processing Accident & Health insurance claims. The ideal candidate should be highly detail-oriented, precise, and able to follow and interpret guidelines and requirements. Essential Duties & Functions Reasonable accommodations may be made to enable individuals to perform the essential functions. Demonstrate fundamentally sound claim handling by achieving compliance in the areas of investigation, coverage and processing of claims Timely and appropriately communicate with the claimant and client, as well as internally Establish proof of loss by reviewing medical documentation; assembling additional information as required from outside sources; including claimant, client, provider, and other insurance companies Calculates and pays benefits due; approves and makes timely claim payments and adjustments Ensure legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients Recognize and properly address coverage issues, potential fraud, and subrogation Ensure claim files are properly documented through internal notes and correspondence logs, and claim coding is correct Refers cases as appropriate to Manager Job Skills Team Player Excellent verbal and written communication Prioritize tasks appropriately and maintain organization Advanced critical thinking and problem-solving skills Strong decision-making ability and sound judgement Build client relationships Self-starter and self-disciplined in accomplishing tasks Ability to work unsupervised Willingness to obtain Insurance Adjuster License Job Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Required/Preferred Education and Experience Required Education: Bachelor's Degree or Equivalent Experience Preferred Experience: 1-3 years insurance experience, medical billing or coding experience Preferred Licensure: Accident & Health Adjuster License Position Type and Expected Hours of Work This is a full-time position. The role is open to candidates who are in a fully remote, hybrid, or on-site role. One full week of on-site training is required at the start of employment. Days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. The schedule for this role can be contingent upon Supervisor and Human Resources approval. Some evening and weekend work may be required. Travel Limited travel would be encouraged for trainings or team meetings. This would be discussed ahead of time and agreed upon between both Supervisor and employee. EEO Statement A-G is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of harassment, discrimination, or retaliation based on the following protected classes: age (40 and older), race, color, national origin, ancestry, religion, sex, sexual orientation (including transgender status, gender identity or expression), pregnancy (including childbirth, lactation, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed servicemember status, or any other status protected by federal, state, or local laws. A-G is dedicated to the fulfillment of this policy in regard to all aspects of employment, including, but not limited to, recruiting, hiring, placement, transfer, training, promotion, rates of pay, other compensation, termination, and all other terms, conditions, and privileges of employment. A-G will conduct a prompt and thorough investigation of all allegations of discrimination, harassment, or retaliation, or any violation of the Equal Employment Opportunity Policy in a confidential manner. A-G will take appropriate corrective action, if and where warranted. A-G prohibits retaliation against team members who provide information about, complain about, or assist in the investigation of any complaint of discrimination or violation of the Equal Employment Opportunity Policy. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
    $29k-54k yearly est. 60d+ ago
  • Arch Capital Services LLC - Associate Claims Examiner, application via RippleMatch

    Ripplematchinterns

    Claim Processor Job 18 miles from Lansdale

    This role is with Arch Capital Services LLC. Arch Capital Services uses RippleMatch to find top talent. About This Program This position is intended for a candidate seeking growth opportunity in a dynamic organization. The Associate Claims Examiner will join a specific business unit, as assigned, and will receive ongoing on-the-job training in their line of business. The Associate also will be part of the company's Early Career Program. The Early Career Program Claims Track is a one-year training program geared toward ambitious college graduates looking to launch a high-performing career in claims with a world-wide insurance leader. During the one-year program, associates receive specialized training that can position them for career advancement and valuable industry certifications. About This Role As the Associate develops skill and gains experience, on-the-job responsibilities will include but are not limited to: Manage Claims on behalf of Arch Customers Receive exposure to other areas within the Administration and Operations of Claim handling, including but not limited to Special Investigations Unit, Analytics, Subrogation. Perform claim handling responsibilities included but not limited to: Coverage analysis, Exposure analysis, Resolution strategies, Claims review, and Customer Service Desired Skills Actively completing or recently completed an area of study in Insurance & Risk Management, Business, Liberal Arts, Communications, psychology, Languages, or relevant degree. Minimum 3.0 GPA or higher. Highly proficient with Microsoft Office tools including Word, Excel, and Outlook. Exemplary oral and written communication skills. Analytical, with keen ability to think through issues. Proactive; able to organize and prioritize to meet multiple demands and commitments. Strong work ethic; team player; exhibits leadership potential. Location & Work Arrangement The Early Careers Program (ECP) begins July 2025. A new hire for this role would start between January - June 2025. This position is classified as a hybrid position. You will work 2 days onsite and 3 days from home. This position can be located in Jersey City, NJ, New York City, NY, Philadelphia, PA, or Morristown, NJ Relocation and housing assistance is not provided for this role. Timeline This position will be posted from December 2024 and will be unposted when filled.
    $29k-54k yearly est. 6h ago
  • Claims Specialist - Construction Professional

    XL Group 4.4company rating

    Claim Processor Job 22 miles from Lansdale

    Claims Specialist - Construction Professional Liability Exton, PA; Philadelphia, PA; or NYC, NY, Morristown, NJ/ USA Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle even 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. And you build a team of passionate and innovative claims experts who see success as a reason to roll up their sleeves and drive for improvement. As a Construction Professional Liability Claims Specialist, you will play a critical role in managing and resolving AXA XL's claims for the Construction Professional Liability team. You will work closely with your manager, fellow Claims Specialists, claim consultants and outside vendors to drive files to resolution and will interact and collaborate frequently with Regional Claims Practice Leaders and the Underwriting team. Together, you will be tasked with achieving the best possible outcomes for AXA XL and its clients by resolving and settling claims proactively. DISCOVER your opportunity What will your essential responsibilities include? * Managing assigned claims across multiple jurisdictions, as well as setting the case strategy for these claims in partnership with Regional Claims Practice Leaders, Claims Legal and Claims management, as warranted. * Proactively managing external counsel and setting litigation strategies when counsel is engaged on a claim. * Coordinating and managing communication with internal and external stakeholders (e.g., underwriting, brokers, reinsurers, external vendors, etc.) to ensure the highest level of customer service. * Consulting with Regional Claims Practice Leaders and Claims management on Large Losses and ensuring all steps are taken to achieve the best outcome for the client and AXA XL. * Documenting as necessary claim activity in our claim system in accordance with our Global Claim Handling Principles, which includes the establishment and maintenance of appropriate reserves. * The production of internal reports and * Identifying, monitoring and reporting on emerging liability and coverage trends. You will report to the Manager of Construction Professional Liability Claims. We're looking for someone who has these abilities and skills: * Professional Liability claims experience: Beginner to Intermediate level experience managing construction claims or Professional Liability construction claims or similar experience in the construction or design professional field. Experience assessing and managing coverage issues and managing high exposure and complex claims. Demonstrated experience negotiating and settling complex claim files. * Excellent Communication: Excellent verbal and written communication, presentation and negotiation skills. Able to communicate and negotiate effectively with internal and external stakeholders at various levels of sophistication. * Collaborative approach: Develop productive working relationships with insured, brokers, claim handlers, underwriters and legal counsel. Seek input from others as needed to achieve the best result possible. Capable of working and collaborating with a virtual team. * Ethics: Handle responsibilities with integrity and the highest standards of professionalism. * Passion for results: Approach tasks proactively and anticipate needs. Think quickly and prioritize multiple work streams without sacrificing quality. Act with a sense of urgency. * Intellectual curiosity: Willing to ask questions and explore new ideas. Eager to learn and focused on continuously improving technical skills. * JD Required. FIND your future 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 strong 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 Diversity & Inclusion We know that a diverse workforce and inclusive culture enable business growth and are critical to our success. That's why we have made a strategic commitment to attracting and retaining the most diverse workforce possible, while creating a strong, inclusive culture where everyone is welcome and can contribute and reach their highest potential. * Named to the Diversity Best Practices Index - 2017, 2018 * Signatory to the CEO Action for Diversity * Signatory to the UK Women in Finance Charter * Twelve Colleague Resource Groups around the Globe * Robust support for Flexible Working Arrangements * Enhanced family friendly leave benefits 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. pay range for this position is $83,500 - $145,500. 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.
    $83.5k-145.5k yearly 9d ago
  • Property Claim Rep Trainee

    The Travelers Companies 4.4company rating

    Claim Processor Job 6 miles from Lansdale

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $48,700.00 - $80,400.00 Target Openings 1 What Is the Opportunity? This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. However, this role will cover around the Philadelphia, Bucks, Montgomery, Delaware and Chester area so you must live in or around these territories to be considered. This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. What Will You Do? * Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. * The on the job training includes practice and execution of the following core assignments: * Handles 1st party property claims of moderate severity and complexity as assigned. * Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. * Broad scale use of innovative technologies. * Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. * Establishes timely and accurate claim and expense reserves. * Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. * Negotiates and conveys claim settlements within authority limits. * Writes denial letters, Reservation of Rights and other complex correspondence. * Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. * Meets all quality standards and expectations in accordance with the Knowledge Guides. * Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. * Manages file inventory to ensure timely resolution of cases. * Handles files in compliance with state regulations, where applicable. * Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. * Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. * Identifies and refers claims with Major Case Unit exposure to the manager. * Performs administrative functions such as expense accounts, time off reporting, etc. as required. * Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. * May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. * Must secure and maintain company credit card required. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. * In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. * This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred. * Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic * Verbal and written communication skills -Intermediate * Attention to detail ensuring accuracy - Basic * Ability to work in a high volume, fast paced environment managing multiple priorities - Basic * Analytical Thinking - Basic * Judgment/ Decision Making - Basic * Valid passport preferred. What is a Must Have? * High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required. * Valid driver's license - required. What Is in It for You? * Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. * Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. * Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. * Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. * Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************
    $48.7k-80.4k yearly 24d ago
  • Technical Claims Supervisor, Major Case Unit

    Arch Capital Group Ltd. 4.7company rating

    Claim Processor Job 18 miles from Lansdale

    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℠. Arch Insurance Group, AIGI, is looking for an experienced claims professional to join its growing Major Case Unit as a Technical Claims Supervisor. The successful candidate will have significant commercial general/auto liability complex/large exposure claim handling experience, a passion for achieving excellent claim results and for delivering exceptional customer service. Responsibilities include, actively managing and effectively overseeing large exposure and complex general/auto liability and trucking claims (primary, umbrella and excess) direct handled by Third-party Administrators ("TPA's") and supporting Arch business stakeholders. Please note this role does not require managing any direct reports but is responsible for managing the claims & TPA process. Specific duties include but not limited to the below: * Deliver industry leading technical claim handling/oversight, claim outcomes, business support and customer service. Make claim services an Arch competitive advantage. * Collaborate with TPA team members, Arch Claim Account Managers ("CAM's") and other claim professionals to proactively develop and effectively execute on appropriate claim resolution strategies * Work closely with underwriters, Legal, Operations, claim professionals, and other Arch functions, to ensure timely and effective communication consistent with Arch Claims' Procedures, striving to achieve optimum claim outcomes * Effective and timely communication with insureds and brokers; making exceptional customer service a top priority * Coverage analysis, investigation, liability and damage evaluation, timely and accurate indemnity and expense reserving (within specific granted authority), litigation management, vendor management, settlement negotiations, including use of structure settlements where appropriate, and claim resolution * Effective claim file documentation, claim coding and diary management * Retain and work closely with defense and coverage counsel to create and execute on litigation/coverage strategies and budgets. Analyze and pay legal bills, consistent with claims specific strategy/budget and Arch Claims Litigation Management Guidelines * Effective and timely claim reporting (verbal and written) to other claim professionals/management and business stakeholders, per Arch Claims Procedures * Attend mediations, trials, other proceedings and meetings * Maintains all required state adjustor licenses * Assist CAM's and others with TPA management and oversight to include: * TPA claim staff training relating to Arch processes, procedures, expectations, reporting, technical claim handling, litigation/vendor management, legal/regulatory developments, customer service and other topics that may arise * Sharing of claim handling/customer service best practices * Assistance with claim file reviews and claim audits * Regular meetings with TPA claims staff Desired Skills: * Minimum of 10 years commercial general/auto liability claim handling experience, including responsibility for complex and large exposure claims, or insurance defense/coverage practicing attorney with similar law firm experience. * Trucking, construction, emergency service/medical professional liability claim handling experience is a plus * TPA management/oversight experience is a plus * Excellent customer service skills and service minded * Strong analytical and problem solving skills * Strong negotiation skills * Exceptional communication (written and verbal), collaboration, influencing, listening, and interpersonal skills to effectively develop productive working relationships both within and outside Arch * Able to process large amounts of complex information, distill it down to key issues and decision points and concisely communicate the information verbally and in writing * Able to effectively lead strategic discussions and leverage technical knowledge to make sound, cost-effective decisions and recommendations * Able to work well independently and in a highly collaborative team environment * Adaptable and able to succeed in a rapidly changing workplace * Strong Microsoft Excel, PowerPoint and Word skills * Willing and able to travel approximately up to 10% of time * This will be a hybrid role in office 2 days a week. Education: * Juris Doctorate desired, but not required #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. $140,000 - $165,000/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. 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.
    $140k-165k yearly 17d ago
  • Claims Specialist, Motor Truck Cargo/Ocean Marine

    CNA Financial Corp 4.6company rating

    Claim Processor Job 15 miles from Lansdale

    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 primarily motor truck cargo claims with moderate to high complexity and exposure. There may also be opportunity to handle ocean marine claims. 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 motor truck cargo claims handling, liability analysis, policy 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, Maryland, New York and Washington, the national base pay range for this job level is $49,000 to $98,000 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 ***************************.
    $49k-98k yearly 47d ago
  • Regional Claims Specialist (I/II/Sr.)

    NJM Insurance 4.7company rating

    Claim Processor Job 28 miles from Lansdale

    NJM's Workers' Compensation Claims Team is seeking a Regional Claims Specialist (I/II/Sr.). This is a full-time position and offers a hybrid schedule after training. The Regional Claims Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim, and outlining and recommending an action plan to manage the claim. The Regional Claim Specialist will work with and communicate to all internal and external stakeholders, including: NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, the NJM Special Investigation Unit, WC Legal Staff, and other departments within NJM, as well as outside defense counsel and vendors. This role is based in our NJM's West Trenton office location. Hours: Monday to Friday 8:00AM- 4:15PM (Hours can very depending on start time). Responsibilities: + Execute on strategic and operational goals and objectives of the WCC department and company business goals, guidelines, and programs + Recommend process improvement where applicable to best improve the department efficiency, work product, and service commitment to interested parties + Manage litigated claims through with proactive execution of action plans to resolve claim issues to move cases toward closure and reduce aged inventory + Ensure quality management of claims in accordance with claims best practices and company guidelines, and timely, accurate documentation of claim activity + Provide a high level of customer service that promotes injured worker advocacy-based principles to maximize return to work motivation and improve outcomes for all parties. + Determine compensability and coverage issues that have been placed in litigation by gathering medical and factual evidence + Administer the delivery of timely, appropriate, and accurate indemnity and medical benefits + Evaluate the claim for potential fraud indicators and escalates the file to SIU, as appropriate. + Recognize and investigate subrogation opportunity for recovery of third-party funds + Initiate and provide excellent communication with all stakeholders (injured workers, providers, attorneys, brokers, clients, etc.) professionally and proactively with a customer-centric approach + Apply critical thinking skills to evaluate and mitigate exposures, and establish and implement a proactive strategic plan of action + Assign and refer claim petitions to Counsel, and work to resolve the claim within given authority + Promptly manage and resolve issues on litigated cases, inclusive of evaluating claim exposure, negotiating, and resolving claims + Build rapport with the policyholder, conduct on-site investigations when necessary, and educate the policyholder on NJM legal procedures, policies, and claim practices + Prepare for Claim Reviews; attend and participate as needed with the Claims Team and Supervisor + Participate in in-house and outside training programs to keep current on relevant issues/topics + Demonstrate a commitment to NJM's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work Required Qualifications and Experience: + Level I - 1 -3 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. + Level II - 3-5 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. + Sr Level - 5+ years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including advanced knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. + Knowledge of WC regulations and jurisdiction(s) to be able to formulate a Plan of Action to bring claims to resolution + Knowledge of and experience working Work with liens and Medicare Set-Asides to secure full and final settlements + Customer service oriented with strong written and oral communication skills + Strong interpersonal skills with ability to work both in a team and independently + Demonstrated organizational skills, and use of sound decision-making capabilities + Working knowledge utilizing an automated claim processing system and the Microsoft Office suite of tools (Word, Excel) + Ability to travel for business purposes, approximately less than 10% Preferred: + Multi-state experience and/or licensing (including NJ, MD, CT, DE, PA and/or NY) + Associate's or Bachelor's degree + AIC/CPCU Designations Salary: The position can be filled at a I, II, or Sr. level. Salary is commensurate with experience and credentials. + Level I- $57K+ annually based on experience and credentials + Level II - $65K+ annually based on experience and credentials + Sr Level - $79K+ annually based on experience and credentials Benefits Offered: + Medical Insurance (Blue Cross Blue Shield) + Dental Insurance (Delta Dental) + Vision (Delta Vision/ VSP) + Flexible Spending Account + Discounts on NJM auto insurance + Tuition reimbursement + Life insurance + Plus, additional company discounts for items like travel, service, car rental and more! Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
    $57k-79k yearly 18d ago
  • Property Claim Rep Trainee

    Travelers Indemnity Co

    Claim Processor Job 18 miles from Lansdale

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job CategoryClaimCompensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range$48,700.00 - $80,400.00Target Openings1What Is the Opportunity?This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. However, this role will cover around the Philadelphia, Bucks, Montgomery, Delaware and Chester area so you must live in or around these territories to be considered. This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.What Will You Do? Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. The on the job training includes practice and execution of the following core assignments: Handles 1st party property claims of moderate severity and complexity as assigned. Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. Broad scale use of innovative technologies. Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. Establishes timely and accurate claim and expense reserves. Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Negotiates and conveys claim settlements within authority limits. Writes denial letters, Reservation of Rights and other complex correspondence. Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. Meets all quality standards and expectations in accordance with the Knowledge Guides. Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. Manages file inventory to ensure timely resolution of cases. Handles files in compliance with state regulations, where applicable. Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. Must secure and maintain company credit card required. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position Perform other duties as assigned. What Will Our Ideal Candidate Have? Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred. Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic Verbal and written communication skills -Intermediate Attention to detail ensuring accuracy - Basic Ability to work in a high volume, fast paced environment managing multiple priorities - Basic Analytical Thinking - Basic Judgment/ Decision Making - Basic Valid passport preferred. What is a Must Have? High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required. Valid driver's license - required. What Is in It for You? Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************
    $48.7k-80.4k yearly 23d ago
  • ESIS Claims Specialist, WC

    Chubb 4.3company rating

    Claim Processor Job 18 miles from Lansdale

    The Workers' Compensation Senior Claims Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. MAJOR DUTIES & RESPONSIBILITIES: Duties may include but are not limited to: Receive assignments. Reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business. Contacts, interviews, and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information. Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company's obligation to the insured under the policy contract. Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc. Sets reserves within authority limits and recommends reserve changes to Team Leader. Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions. Prepares and submits to Team Leader unusual or possible undesirable exposures. Assists Team Leader in developing methods and improvements for handling claims. Settles claims promptly and equitably. Obtains releases and timely issues indemnity benefits if due and owing. Informs claimants, insureds/customers, or attorney of denial of claim when applicable. May assist Team Leader and company attorneys in preparing cases for trial by taking statements. Continues efforts to settle claims before trial. Refers claims to subrogation as appropriate. May participate in claim file reviews and audits with customer/insured and broker. Administers Workers' Compensation benefits timely and appropriately per Jurisdiction. Maintains control of claim's resolution process to minimize current exposure and future risks Establishes and maintains strong customer relations OTHER DUTIES MAY INCLUDE: Working all queues and diary in a timely manner Investigating compensability and benefit entitlement Reviewing and approving medical bill payments Managing vocational rehabilitation DESIRED QUALIFICATIONS: 5-7 years' experience handling Workers' Compensation claims Knowledge of claims handling and familiarity with claims terminologies Effective negotiation skills Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses. Ability to self-motivate and work independently, excels in organization and time management skills Knowledge of company products, services, coverages, and policy limits, along with awareness of the company's claims best practices and client service instructions Knowledge of applicable state and local laws. ESIS, a multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management. The Workers' Compensation Senior Claims Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. MAJOR DUTIES & RESPONSIBILITIES: Duties may include but are not limited to: Receive assignments. Reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business. Contacts, interviews, and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information. Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company's obligation to the insured under the policy contract. Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc. Sets reserves within authority limits and recommends reserve changes to Team Leader. Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions. Prepares and submits to Team Leader unusual or possible undesirable exposures. Assists Team Leader in developing methods and improvements for handling claims. Settles claims promptly and equitably. Obtains releases and timely issues indemnity benefits if due and owing. Informs claimants, insureds/customers, or attorney of denial of claim when applicable. May assist Team Leader and company attorneys in preparing cases for trial by taking statements. Continues efforts to settle claims before trial. Refers claims to subrogation as appropriate. May participate in claim file reviews and audits with customer/insured and broker. Administers Workers' Compensation benefits timely and appropriately per Jurisdiction. Maintains control of claim's resolution process to minimize current exposure and future risks Establishes and maintains strong customer relations OTHER DUTIES MAY INCLUDE: Working all queues and diary in a timely manner Investigating compensability and benefit entitlement Reviewing and approving medical bill payments Managing vocational rehabilitation DESIRED QUALIFICATIONS: 5-7 years' experience handling Workers' Compensation claims Knowledge of claims handling and familiarity with claims terminologies Effective negotiation skills Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses. Ability to self-motivate and work independently, excels in organization and time management skills Knowledge of company products, services, coverages, and policy limits, along with awareness of the company's claims best practices and client service instructions Knowledge of applicable state and local laws. ESIS, a multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.
    $92k-120k yearly est. 4d ago
  • Damage Claims Specialist

    HTSS, Inc.

    Claim Processor Job 26 miles from Lansdale

    Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company’s tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries. Job Qualifications: Bachelor’s Degree (preferred); High School Diploma or equivalent (required) Minimum of three (3) years experience in claims handling Proficiency in Microsoft Office Suite, especially Word and Excel Strong verbal and written communication skills Excellent problem-solving and conflict-resolution abilities High attention to detail and ability to work independently Pay: Based on experience This is a full-time, temporary role expected to last at least 6 months. If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
    $40k-71k yearly est. Easy Apply 2d ago
  • Claims Clerk

    Repwest Insurance Company

    Claim Processor Job 12 miles from Lansdale

    Repwest Insurance Company is looking for a Claims Clerk to join their team. We are seeking a dynamic individual to provide support functions for office staff and handle a multi-line phone system. Cross-training will occur on all facets of the support staff functions. This employee will report to our Pennsylvania Claims Office. Requirements: Dependable, self-starter with attention to detail Good Communication and organizational skills Must have two to three years of insurance or office experience related to all fundamental skills and knowledge in the insurance office setting Knowledge and experience with MS Windows, Word, and Excel Republic Work Status: Full Time U-Haul/Repwest Offers: Full Medical Coverage Prescription plans Dental & Vision Plans Registered Dietitian Program Gym Reimbursement Program Weight Watchers Virtual Doctors' Visits Career stability Opportunities for advancement Valuable on-the-job training Tuition reimbursement program Free online courses for personal and professional development at U-Haul University Business travel insurance You Matter Employee Assistance Program Paid holidays, vacation, and sick days Employee Stock Ownership Plan (ESOP) 401(k) Savings Plan Life insurance Critical Illness/Group Accident 24-hour physician available for kids MetLaw Legal program MetLife auto and home insurance Mindset App Program Discounts on cell phone plans, hotels, and more LifeLock Identity Theft Savvy consumer wellness programs - from health care tips to financial wellness Dave Ramsey's SmartDollar Program U-Haul Federal Credit Union U-Haul Holding Company, and its family of companies including U-Haul International, Inc. (“U-Haul”), continually strives to create a culture of health and wellness. Consistent with applicable state law, U-Haul will not hire or re-hire individuals who use nicotine products. The states in which U-Haul will decline to hire nicotine users are: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Pennsylvania, Texas, Utah, Vermont, Virginia, and Washington. U-Haul has observed this hiring practice since February 1, 2020 as part of our commitment to a healthy work environment for our team. U-Haul is an equal opportunity employer. All applicants for employment will be considered without regard to race, color, religion, sex, national origin, physical or mental disability, veteran status, or any other basis protected by applicable federal, provincial, state or local law. Individual accommodations are available on requests for applicants taking part in all aspects of the selection process. Information obtained during this process will only be shared on a need to know basis.
    $30k-37k yearly est. 60d+ ago
  • Certification Specialist - Walnut Park

    CRM Residential 3.6company rating

    Claim Processor Job 18 miles from Lansdale

    CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day. Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference. Why Join the CRM Residential Team: Comprehensive Health Coverage Retirement Savings with employer contribution Bonus Potential Paid Time Off (PTO) Company Paid Holidays What You'll Get To Do: The Recertification Specialist will receive general supervision and direction from the Community Manager. The Recertification Specialist will comply with established policies and authorized approval. Recertification Specialist responsibilities include, but are not limited to the following: Resident selection and orientation in accordance with the Resident Selection Plan Assist with the leasing of vacant apartments in an expeditious manner per company policy striving for 100% occupancy Handle the timely recertification and interim recertifications of residents in accordance with HUD regulation and Low-Income Housing Tax Credit Program Maintain the waiting list book and keeping it up to date in the computer following HUD regulations Assist with the development of goals and objectives for the property Maintain resident files according to policy outlined in CRM's Occupancy Manual Assist Property Manager in preparation of various file reviews such as: Management Review Mortgagee Inspection Accept daily resident requests and write up corrective work orders as directed by the Maintenance Plus program Daily management of office duties Maintain an open office at prescribed times Immediately handle daily work orders that come in Take applications for prospective residents Compute applications for eligibility, with supporting documents Send out billing notices Greet in-coming guests, respond to mail and handle all incoming telephone calls Maintain a professional demeanor Attend required trainings In absence of the Community Manager, enforcement of the lease and the rules and regulations Completion of all required reports as directed by various departments of CRM Residential Required to observe all federal and local Fair Housing Laws Perform other related duties, as assigned Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. 1-2 years of certification experience required HUD experience required Must have experience with recertifications, RealPage OneSite, and inspections The position requires effective oral and written communication skills Proficiency in Microsoft Office (Excel and PowerPoint in particular) Ability to work with a variety of people and make them feel comfortable quickly Must be able to multi-task Ability to work any scheduled hours as well as additional hours needed to complete the job The position requires effective oral and written communication skills Strong customer service skills required Must have strong organizational and time management skills About CRM Residential: CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients. We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a desire to work for a reputable company, we encourage you to apply for this exciting opportunity.
    $28k-37k yearly est. 19d ago
  • Associate Claims Specialist - General Liability & Auto, Multinational

    XL Group 4.4company rating

    Claim Processor Job 22 miles from Lansdale

    Exton| United States of America Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle even 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. You build a team of passionate and innovative claims experts who see success as a reason to roll up their sleeves and drive for improvement. As an Associate Claims Specialist, you will play a critical role in handling and resolving AXA XL's claims for the Multinational Casualty team. You will work closely with your manager and fellow claims colleagues to drive files to resolution and will interact and collaborate frequently with the underwriting team and other business partners. Together, you will be tasked with achieving the best possible outcomes for AXA XL and its insureds by resolving and settling claims proactively. DISCOVER your opportunity Key responsibilities of this role are: * Reviewing coverage under policies and handling assigned claims across multiple jurisdictions as well as setting case strategy for these claims in partnership with colleague mentors and claims management. * Partner with internal and external counsel in setting and pursuing effective and cost-efficient litigation strategies for claims in litigation. * Coordinating and managing communication with internal and external stakeholders (underwriting, brokers, reinsurers, external vendors, etc.) to ensure the highest level of customer service. Participation in new account and renewal meetings may be required. * Collaborate and work with colleague mentors to develop knowledge to set claim handling, reserve and resolution strategies. * Producing internal reporting and ensuring that reserves are set according to best practices guidelines. * Identifying, monitoring and reporting on emerging liability and coverage trends You will report to the Head of Multinational Casualty, Americas. SHARE your talent We're looking for someone who has these abilities and skills: * Experience in a claim handling role preferred * Effective organizational skills. * Possess analytical skills and sound judgment. * Interpersonal Communication: Excellent verbal, written and collaborative communication skills. Able to communicate effectively with internal and external stakeholders. Ability to work in a fast-paced environment and efficiently juggle numerous concurrent responsibilities. * Collaborative Approach: Develop and maintain productive working relationships with insured, brokers, Claim Handlers & Underwriters. Provide guidance and seek input from others as needed to achieve the best results. Capable of working and collaborating within a virtual team environment with either local or remote supervision. * Results Oriented: Approach tasks proactively and anticipate needs. Think quickly and prioritize multiple work streams without sacrificing quality. * Continuous Improvement Mindset: Willing to ask questions and explore new ideas. Eager to learn and focused on continuously improving technical skills. * Client-Service Focused: Demonstrate value add in the claims experience, delivering on our promise to clients. Ability to meet or exceed Performance Competencies. FIND your future 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 Inclusion & Diversity 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 a diverse workforce enable business growth and are critical to our success. That's why we have made a strategic commitment to attract, develop, advance and retain the most diverse workforce possible, and create an inclusive culture where everyone can bring their full selves to work and can 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 axaxl.com/about-us/inclusion-and-diversity. AXA XL is an Equal Opportunity Employer. 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 axaxl.com/sustainability The U.S. pay range for this position is $73,800-116,500. 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.
    $73.8k-116.5k yearly 9d ago
  • Regional Claims Specialist (I/II/Sr.)

    New Jersey Manufacturers Ins 4.7company rating

    Claim Processor Job 28 miles from Lansdale

    NJM's Workers' Compensation Claims Team is seeking a Regional Claims Specialist (I/II/Sr.). This is a full-time position and offers a hybrid schedule after training. The Regional Claims Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim, and outlining and recommending an action plan to manage the claim. The Regional Claim Specialist will work with and communicate to all internal and external stakeholders, including: NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, the NJM Special Investigation Unit, WC Legal Staff, and other departments within NJM, as well as outside defense counsel and vendors. This role is based in our NJM's West Trenton office location. Hours: Monday to Friday 8:00AM- 4:15PM (Hours can very depending on start time). Responsibilities: Execute on strategic and operational goals and objectives of the WCC department and company business goals, guidelines, and programs Recommend process improvement where applicable to best improve the department efficiency, work product, and service commitment to interested parties Manage litigated claims through with proactive execution of action plans to resolve claim issues to move cases toward closure and reduce aged inventory Ensure quality management of claims in accordance with claims best practices and company guidelines, and timely, accurate documentation of claim activity Provide a high level of customer service that promotes injured worker advocacy-based principles to maximize return to work motivation and improve outcomes for all parties. Determine compensability and coverage issues that have been placed in litigation by gathering medical and factual evidence Administer the delivery of timely, appropriate, and accurate indemnity and medical benefits Evaluate the claim for potential fraud indicators and escalates the file to SIU, as appropriate. Recognize and investigate subrogation opportunity for recovery of third-party funds Initiate and provide excellent communication with all stakeholders (injured workers, providers, attorneys, brokers, clients, etc.) professionally and proactively with a customer-centric approach Apply critical thinking skills to evaluate and mitigate exposures, and establish and implement a proactive strategic plan of action Assign and refer claim petitions to Counsel, and work to resolve the claim within given authority Promptly manage and resolve issues on litigated cases, inclusive of evaluating claim exposure, negotiating, and resolving claims Build rapport with the policyholder, conduct on-site investigations when necessary, and educate the policyholder on NJM legal procedures, policies, and claim practices Prepare for Claim Reviews; attend and participate as needed with the Claims Team and Supervisor Participate in in-house and outside training programs to keep current on relevant issues/topics Demonstrate a commitment to NJM's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work Required Qualifications and Experience: Level I- 1-3 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. Level II- 3-5 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. Sr Level - 5+ years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including advanced knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. Knowledge of WC regulations and jurisdiction(s) to be able to formulate a Plan of Action to bring claims to resolution Knowledge of and experience working Work with liens and Medicare Set-Asides to secure full and final settlements Customer service oriented with strong written and oral communication skills Strong interpersonal skills with ability to work both in a team and independently Demonstrated organizational skills, and use of sound decision-making capabilities Working knowledge utilizing an automated claim processing system and the Microsoft Office suite of tools (Word, Excel) Ability to travel for business purposes, approximately less than 10% Preferred: Multi-state experience and/or licensing (including NJ, MD, CT, DE, PA and/or NY) Associate's or Bachelor's degree AIC/CPCU Designations Salary: The position can be filled at a I, II, or Sr. level. Salary is commensurate with experience and credentials. Level I- $57K+ annually based on experience and credentials Level II - $65K+ annually based on experience and credentials Sr Level - $79K+ annually based on experience and credentials Benefits Offered: Medical Insurance (Blue Cross Blue Shield) Dental Insurance (Delta Dental) Vision (Delta Vision/ VSP) Flexible Spending Account Discounts on NJM auto insurance Tuition reimbursement Life insurance Plus, additional company discounts for items like travel, service, car rental and more! Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
    $57k-79k yearly 15d ago
  • Property Claim Rep Trainee

    Travelers Insurance Company 4.4company rating

    Claim Processor Job 18 miles from Lansdale

    **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $48,700.00 - $80,400.00 **Target Openings** 1 **What Is the Opportunity?** This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. However, this role will cover around the Philadelphia, Bucks, Montgomery, Delaware and Chester area so you must live in or around these territories to be considered. This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. **What Will You Do?** + Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. + The on the job training includes practice and execution of the following core assignments: + Handles 1st party property claims of moderate severity and complexity as assigned. + Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. + Broad scale use of innovative technologies. + Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. + Establishes timely and accurate claim and expense reserves. + Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. + Negotiates and conveys claim settlements within authority limits. + Writes denial letters, Reservation of Rights and other complex correspondence. + Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. + Meets all quality standards and expectations in accordance with the Knowledge Guides. + Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. + Manages file inventory to ensure timely resolution of cases. + Handles files in compliance with state regulations, where applicable. + Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. + Must secure and maintain company credit card required. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. + This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred. + Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic + Verbal and written communication skills -Intermediate + Attention to detail ensuring accuracy - Basic + Ability to work in a high volume, fast paced environment managing multiple priorities - Basic + Analytical Thinking - Basic + Judgment/ Decision Making - Basic + Valid passport preferred. **What is a Must Have?** + High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required. + Valid driver's license - required. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .
    $48.7k-80.4k yearly 24d ago
  • Certification Specialist - Woodstock

    CRM Residential 3.6company rating

    Claim Processor Job 18 miles from Lansdale

    CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day. Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference. Why Join the CRM Residential Team: Comprehensive Health Coverage Retirement Savings with employer contribution Bonus Potential Paid Time Off (PTO) Company Paid Holidays What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Previous certification experience required HUD experience required Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills The position requires effective oral and written communication skills Must have Tax Credit experience Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Experience with realpage onesite Experience with inspections Full Time 8:30am-4:30pm About CRM Residential: CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients. We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity.
    $28k-37k yearly est. 27d ago

Learn More About Claim Processor Jobs

How much does a Claim Processor earn in Lansdale, PA?

The average claim processor in Lansdale, PA earns between $22,000 and $70,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average Claim Processor Salary In Lansdale, PA

$40,000
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