Claim Processor jobs in New Brunswick, NJ

The Voluntary Benefits Claims Examiner will support a large Group Insurance Business contract is responsible for the calculation of Voluntary Benefits across limited products according to Plan Provisions. Voluntary Benefits can include wellness, hospital indemnity, accident and critical illness products. This position requires the knowledge and understanding of Voluntary Benefits policies and procedures with a medical terminology background and ability to read medical records outside of ICD's, CPTs and HCPC to appropriately calculate the benefits due. You will be expected to follow through timely on claim processing, utilize judgment, and assess risk when rendering claim decisions. Able to communicate with various constituents with limited guidance and learn and transact using the client s systems. Expected to communicate clearly concisely to influence return to work, discuss terms of the certificate, and the basis of payment nonpayment. Key Responsibilities: * Document all claim information including phone calls and correspondence. * Utilize effective communication to obtain information both verbally and in writing and provide information to the claimant and employer. * Ability to read multiple pages of medical records to confirm benefits available to the member. * Ability to apply plan provisions understand the needs of the clients. * Expected to adhere to client Service Level Agreements and department s product s key performance requirements and any reporting. * Able to utilize strong organizational skills to manage multiple priorities while working under tight time constraints, possess the ability to work through ambiguity, and work effectively with various vendors with strong interpersonal skills. * Willing to support special internal functional projects and ad hoc requests as required. * Able to work cohesively with Subject Matter experts to support the day to day tasks, able to anticipate, identify, and resolve complex issues problems. * Able to communicate risks issues to supervisor and help with the resolution, as needed. * Provide exceptional customer service either over the phone or through email. * Able to provide leadership updates progress reports on training curriculum. * Utilize tools independently and accurately to identify work to be completed. * Professional and detailed verbal skills for outbound calls to obtain medical records or claim details to gather data to work claim to completion. Qualification Basic Qualifications: * Minimum of 6 months experience in Medical Insurance Claims Processing * Minimum of 1 year experience in a contact center/call center. Preferred Qualifications: * Group Life/Disability/ Voluntary Claims experience * Bachelor s Degree * NY Adjustor License * Strong mathematical skills Professional Skills: * Proficiency in Windows environment, including Word and Excel * Medical terminology knowledge * Strong written and verbal communications required * Detailed oriented with strong time management skills Job Requirement: Schedule flexibility to work a schedule from 7 am to 7 pm CST. Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Illinois, Maryland, Minnesota, New Jersey, New York or Washington as set forth below. The application window for this job will remain open until at least 05/13/2025. However, if this date has passed and this role is still posted, please note we are still accepting applications. Information on benefits is here. Role Location Hourly Salary Range California $19.71 to $38.51 Colorado $19.71 to $33.27 District of Columbia $21.01 to $35.43 Illinois $18.27 to $33.27 Minnesota $19.71 to $33.27 Maryland $19.71 to $33.27 New York/New Jersey $18.27 to $38.51 Washington $21.01 to $35.43 Locations

Workers' Compensation Claim Supervisor Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $90,00-$95,000 At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. The Workers' Compensation Claim Supervisor is responsible for the investigation, adjustment and supervision of assigned claims. This position may be used as an advanced training position for consideration for promotion to a management position. Is accountable for the quality of claim services as perceived by CCMSI clients and within our Corporate Claim Standards. Responsibilities Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws. Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws. Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels. Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist designated claim staff in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Direct handling of designated litigated and complex claims. Provide education, training and assist in the development of claim staff. Review and maintain personal diary on claim system. Supervision of all claim activity for specified accounts. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Performs other duties as assigned. 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, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10 + years claim experience is required. Three years supervisory experience is preferred. Bachelor Degree is preferred. Computer Skills Proficient in Microsoft Office products such as Word, Excel, Outlook, etc. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction AIC, CPCU, or ARM preferred Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Object Handling Categories Work requires the ability to lift/carry objects routinely as follows: Light Lifting: No lifting of objects weighing more than 15 pounds on a regular basis. Other Physical Demands Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefit package included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K. #CCMSICareers #CCMSINewYork #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #WorkersCompensation #ClaimsSpecialist #InsuranceCareers #CCMSI #RemoteWork #HybridWork #NYJurisdiction #CareerGrowth #InsuranceJobs #ClaimAdjuster #IND123 #LI-Hybrid We can recommend jobs specifically for you! Click here to get started.

What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure claims. The position will have significant responsibility for decision making and work autonomously within their authority. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims * Analyzes coverage and communicates coverage positions * Conducts, coordinates, and directs investigation into loss facts and extent of damages * Directs and monitors assignments to experts and outside counsel * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure * Sets reserves within authority or makes claim recommendations concerning reserve changes to manager * Negotiates and settles claims either directly or indirectly * Prepares reports by collecting and summarizing information * Adheres to Fair Claims Practices regulations * Assist in training and mentoring of specialists * Serves as technical resource to subordinates and others in the organization * Review and approve correspondence, reports and authority requests as directed by manager * Participates in special projects or assists other team members as requested * Travel to mediations, trials, and conferences as required * Represents Markel's claims expertise on external panels and industry forums * Coordinates loss information for senior business stakeholders and presents during monthly/quarterly business meetings * Contributes to maintenance of claims guidelines and best practice procedures * Delivers construction claims technical training to colleagues and external contacts as appropriate * Ensures effective vendor and litigation management on claims with a focus on minimizing indemnity exposure and mitigating vendor and legal expense * Steps in for manager to assume managerial duties when manager is unavailable or requires assistance Qualifications * Juris Doctor (JD ) Degree preferred * Must have or be eligible to receive claims adjuster license. * Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) or * I-Lead or other Management Training * Minimum of 10 years of claims handling experience or equivalent combination of education and experience * Experience handling high exposure construction bodily injury and property damage claims * Market leading specialist knowledge within casualty construction lines * Expert policy language skills enabling accurate and consistent policy wording interpretation * Experience in negotiation, mediation and arbitrations * Experience in conducting technical claims audits and effectively following up on findings * Ability to manage claims outside of local jurisdiction where appropriate, including understanding of laws and regulations * Strong senior stakeholder management experience, both internal (underwriting, distribution, actuarial, finance and executive management) and external (brokers, major account clients) * Ability to influence claims stakeholders and to effectively direct claims strategy * Ability to lead within a team environment * Strong presentation skills * Excellent written and oral communication skills * Strong analytical and problem solving skills * Strong organization and time management skills * Ability to deliver outstanding customer service * Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word) * Ability to work in a team environment * Strong desire for continuous improvement * Markel offers hybrid working schedules of 3 days in the office and 2 days remote. #LI-SY #LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The national average salary for the Executive Claims Examiner is $90,500 to $150,900 with 25% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.

Liberty Mutual has an immediate opening for an Environmental Complex Claims Specialist. With minimal supervision, the Environmental Complex Claims Specialist will handle a book of Commercial Specialty Lines Claims, throughout the entire claim's life cycle. The Environmental Complex Claims Specialist will be responsible for conducting investigations, recommending adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business. Please note you will be required to go into one of the following GRS Claims Offices at least twice a month if you reside within a 50 mile radius: Westborough, MA; Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Chandler, AZ; Suwanee, GA; or Weatogue, CT. This requirement is subject to change. Responsibilities Analyzes, investigates, and evaluates the loss to determine coverage and claim disposition. Utilizes CMS to document claims and to diary future events or follow-up. Within prescribed settlement authority for line of business, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level. Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting. Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment. Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, within limit of settlement authority. Participates in the claims audit process. Provides claims marketing services by meeting with brokers, risk managers and reinsurers, as necessary. As required, maintains insurance adjuster licenses. Qualifications Bachelors' and/or advanced degree; J.D. preferred. 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred. Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge. Functional knowledge of law and insurance regulations in various jurisdictions. Demonstrated advanced verbal and written communications skills. Demonstrated advanced analytical, decision making and negotiation skills. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally. At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow. We are dedicated to fostering an inclusive environment where employees from all backgrounds can build long and meaningful careers. By actively seeking employee feedback and amplifying the voices of our seven Employee Resource Groups (ERGs), which are open to all, we create an environment where every individual can make a meaningful impact so we continue to meet the evolving needs of our customers. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

The Commercial General Claims department is looking for a Commercial Complex Claims Specialist candidate. The successful candidate must have excellent communication and time management skills as well as a strong organizational background. This individual must be a creative & proactive problem solver, analytical and an independent contributor who can also work as a member of the team. The successful candidate will also be a disciplined self-starter, decisive, owning their decisions and the work they produce. Hours: Monday through Friday, 8:30 a.m. to 4:45 p.m. Hybrid: 2 days from home, 3 days in the office Office: West Trenton, Parsippany or Hammonton (Hybrid opportunity once training is completed) Job Requirements & Responsibilities: Minimum 24 months of Commercial Claims Experience. Outstanding communication & customer service skills with experience in coverage analysis and negotiation. A minimum of 5-10 years claims experience overall, this should include handling of litigated and non-litigated property damage and bodily injury claims related to BOP, CA and CPP policies. Ability to properly prepare reports, letters disclaiming coverage and Reservation of Rights letters. Negotiation skills with a documented history of pro-actively negotiating settlements on larger exposure claims. The ability to work with AND direct defense counsel towards an appropriate resolution on a claim file. Robust presentation skills. Creative and proactive problem solver. Analytical with an ability to prioritize work assignments. Proficient at Microsoft Office. AIC & Licensed as required. Mid to complex coverage issues/litigation BOP/CPP/CA/Excess (all states) Salary: $86,020 - $99,954 (Salary is commensurate with direct experience and credentials) Compensation: Salary is commensurate with experience and credentials. Pay Range: $86,020-$99,954 Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses. 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.

Company Details Berkley Public Entity (BPE) was founded in 2012 as a member company of W.R. Berkley Corporation. BPE is a growing, dynamic company with the vision of being the preeminent carrier in our marketplace. As our name implies, BPE is 100% focused on providing innovative insurance and reinsurance solutions to public entities. We have a welcoming culture valuing our employees - we trademarked the phrase Everything Counts, Everyone Matters to describe the Berkley commitment to our people and how we do business. We believe that every person in the organization is important, and every accomplishment makes a difference in our results. Come join us! The company is an equal opportunity employer. ************************************ Responsibilities The Claims Litigation Specialist role is responsible for the review, oversight and specific handling of General Liability, Automobile Liability, and Professional Liability claims including Law Enforcement and Sexual Abuse involving municipalities, schools, and other public entities. All accounts are written excess of an SIR layer and underlying claims are handled by the insured or their selected TPA until reaching the BPE layer. Identifying and evaluating coverage issues, preparing comprehensive coverage letters and analysis. Identifying and evaluating risk transfer opportunities pursuant to contracts, lease agreements, certificates of insurance. Evaluating information on coverage, liability, and damages to resolve claims on reasonable terms and at an appropriate value. Communicate with insureds, brokers and TPA's to secure additional claim information, communicate loss information, and monitor Self Insured Retentions and determine the extent of exposure to the insured and the company. Sets reserves within authority or makes claim recommendations concerning reserve changes to supervisor. Evaluate claims and make recommendations to management regarding claim resolution plans/strategies. Negotiating settlements. Retaining, directing and managing litigation counsel through trial; developing and managing strategy for complex litigation and reviewing legal bills. Attending arbitrations, mediations, trials. Respond to internal and external requests for information from management, underwriters, business partners etc. Provides outstanding customer service and works well with the insured, broker and TPA in the adjustment of losses. Prepare timely and accurate reports to management regarding significant claim developments. Participate in audits of TPA's to ensure adherence to BPE claims guidelines. Ensure large loss and exposure reporting requirements are met referring claims to BPE management and/or WR Berkley management as necessary. Travel - attend conferences, mediation and/or trials as necessary. Qualifications Bachelor's Degree required. 3-8 years handling General Liability and Auto claims. Public Entity experience highly preferred but not required. Litigation experience necessary. Advanced proficiency with MS Office Suite. #LI-FL1 #LI-HYBRID 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 which for this role includes: Base Salary Range: $75,000 - $90,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Eligible to participate in the annual discretionary bonus program. Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. Sponsorship Details Sponsorship not Offered for this Role

This is your opportunity to join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry. At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process. Job Description AXIS is seeking a Claims Specialist - Management Liability to join our North America Claims team. The selected candidate will work closely with colleagues across AXIS Insurance including North American Claims and International Claims and the Directors & Officers (D&O) and Financial Institutions (FI) Business Units to develop and drive an industry leading claims offering and strategy. This role will be responsible for: * Handling and managing a wide variety of Management Liability Claims under limited supervision, including: Public D&O, Private D&O, Bankers Professional Liability (BPL), Investment Advisors, Private Equity, and Insurance Company Professional Liability (ICPL). Experience with Transactional Liability claims including Representations and Warranties, Judgment Preservation & Contingent Risk is a plus. * Investigation, analysis and evaluation of coverage, liability and damages, within best practices and maintain appropriate documentation * Reviewing Management Liability claims to determine the nature of loss, coverage provided, and scope of claim and to guide strategic direction regarding settlement/disposition of claims * Developing and maintaining relationships with internal and external partners * Escalating coverage issues and recommending outside coverage counsel assignments for approval, where warranted * Formulating claims and litigation strategies, assigning, directing, and managing outside counsel * Evaluate full pending of claims in connection with the posting and maintaining of accurate reserves * Managing costs, including use of coverage counsel and litigation costs as well as collaborating and working with the Litigation Management and Vendor Management teams ensuring cost management and the development and enhancement of panel counsel * Maintain and develop relationships with senior executives, brokers, reinsurers, actuaries, underwriters, insureds, and auditors (both external and internal) * Supporting underwriting inquiries and information requests and drafting, reporting claim trends, data analysis, and risk assessments * Leading and participating in presentations and discussions with Underwriters and Insureds on large losses and claim trends * Participating in claim audits * Participate in special projects and department initiatives. * Other duties as assigned Qualifications: * Juris Doctorate preferred; Admitted to practice a plus * Minimum of 5 years of experience handling Management Liability claims * Required state claims adjuster licenses (or ability to obtain within 90 days of hiring) * Demonstrated ability to work effectively as part of a team and meet deadlines * Experience with KPIs and the "flow" associated with Management Liability claims. Excel skills and experience with Power BI a plus. KEY SKILLS & ABILITIES: * Comfort with evaluating high exposure and complex claims * Excellent oral and written communication skills with the ability to deal effectively with a wide range of stakeholders * Experience presenting to senior management and outside partners * Knowledge of claims and litigation management, dispute resolution processes, and trials and appeals as well as excellent analytical, investigative, and negotiating skills * Travel is associated with this role (off-site meetings, court proceedings, mediations)

Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. Position Overview As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post-paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position will be responsible for responding to inquiries from providers whose claims may be paid incorrectly and performing accurate data entry and maintenance accurate records and files. Job Description Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed using multiple systems and platforms. Ensure that the proper payment guidelines are applied to each claim by using the appropriate tools, processes, and procedures (e.g., claims processing P&P's, grievance procedures, state mandates, CMS/Medicare/Medicaid guidelines, benefit plans, etc.) Research claims that may have paid incorrectly and communicate findings for adjustment; Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts etc.) ensuring that all relevant information is considered. Advise business partners of findings outcome if their input is needed to help fix the issue. Communicate through correspondence with providers regarding claim payment or additional required information in a clear and concise manner. Process the adjustment of claims in a timely manner, according to established timelines. Remain current with changes/updates in claims processing, as well as updates to coding systems. Maintain accurate records of all claims processed, including notes on actions taken. Generate reports on claim activity as requested. Respond to audits of claims processed. Able to work independently and exercise good judgment Minimum Qualifications High School Degree or evidence of having passed a High School Equivalency Program required. Associate degree preferred. Minimum 2 years of claims operations experience in a healthcare field, with knowledge of integrated claims processing required. Experience using a PC and claim adjudication system(s) Experience using Customer Relationship Management (CRM) software; Salesforce is a plus. Experience working with large data and spreadsheets. Knowledge of medical terminology, CPT, ICD-10, and Revenue Codes Processing of Medical Claim Forms (HCFA, UB04) Knowledge of Medical Terminology Knowledge of HIPPA Guidelines regarding Protected Health Information Data Entry of Provider Claim/Billing information Experience handling or familiarity with Medical Claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators. Professional Competencies Integrity and Trust Customer Focus Functional/Technical skills Written/Oral Communication Strong Analytical Skills Knowledgeable in MS Word and Excel #LI-Hybrid #MHP50

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: Manhattan, NY Atlanta, GA Chicago, IL Los Angeles, CA West Hartford, CT About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for both first and third party claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our must-haves: 5+ years of claims handling experience; A JD from an ABA accredited law school may be considered as a supplement to claims handling experience Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred Additional Factors Considered: Ability to act as a subject matter expert within team Demonstrated ability to work independently with minimal oversight Experience attending and leading mediations, arbitrations and trials Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects Well-organized and responsive Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars. Salary range: $115k-$150k 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. What Hiscox USA Offers Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox As an international specialist insurer we are far removed from the world of mass market insurance products. Instead we are selective and focus on our key areas of expertise and strength - all of which is underpinned by a culture that encourages us to challenge convention and always look for a better way of doing things. We insure the unique and the interesting. And we search for the same when it comes to talented people. Hiscox is full of smart, reliable human beings that look out for customers and each other. We believe in doing the right thing, making good and rebuilding when things go wrong. Everyone is encouraged to think creatively, challenge the status quo and look for solutions. Scratch beneath the surface and you will find a business that is solid, but slightly contrary. We like to do things differently and constantly seek to evolve. We might have been around for a long time (our roots go back to 1901), but we are young in many ways, ambitious and going places. Some people might say insurance is dull, but life at Hiscox is anything but. If that sounds good to you, get in touch. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) #LI-AJ1 Work with amazing people and be part of a unique culture

SourceProSearch is seeking a Claims Specialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office. Job Responsibilities: Format documents and communications for clients. Liaise between third-party vendors and the firm. Review documents (release/document verification) for production to defense counsel for quality control. Calendaring and entry of case info into the database. Perform intake and initial filtering of client inquiries. Preparation of submissions involving large volumes of individual claims. Run and analyze client data reports. Organize documents and communications with clients. Ensure that case documents accurately reflect a client's individual information. Keep track of communications or developments relating to client cases and deadlines that may be applicable to individual clients. Prepare and send client communications. Communicate with clients telephonically, on occasion. Work with attorneys to plan data gathering and settlement update workflows. Analyze and summarize client inquiries to identify trends and patterns requiring further action. Assist with the development of processes and technological systems for addressing large volumes of client interactions. Skills/Requirements: Proficient in the use of Microsoft Word and Excel. Familiarity with Filesite preferred. Familiarity with client management systems or databases preferred. Strong technical skills and ability to quickly learn new litigation support software. Strong written and oral communication skills and strong interpersonal skills. Must possess great attention to detail. Must possess analytical and critical thinking skills. Strong organizational and time-management skills. Ability to work independently while understanding the importance of teamwork. Ability to manage workload consisting of multiple tasks. The work shift for this position is 9:30 am-5:30 pm, five days a week, but the applicant must be willing and available to work overtime, both evening and weekends, when necessary. ****************************

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Overview As a Claims Manager within the Arch Insurance Claims organization, you will be responsible for leading a team of Claims Examiners with varying levels of experience in the Direct Claims Resolution Unit (“DRC”). DRC handles a mixed caseload of Commercial Excess and Primary General Liability, Employment Practices Liability, Healthcare, Property, Professional Liability, Cyber, Surety, and Executive Assurance claims. This role reports to the AVP, Claims Shared Services. Primary Responsibilities, specific duties include but not limited to the below: Directly manage a team of Claim Examiners. Provide claim authority and guidance as necessary on specific claims. Provide monthly and quarterly (or as needed) reports . Ensure adjusting staff are compliant with current regulatory requirements. Coordinate training for staff on relevant technical claim handling issues. Collaborate with claim management, legal, and other claim product teams to develop strategies and business plans to reduce claim cost/expenses. Seek guidance from claim leadership on issues that will have an impact on the Company. Oversight of Claims Examiners to ensure all claims are handled within authority limits, and in line with Arch Claims procedures and guidelines. Assist with driving the achievement of financial targets and ensure claims reserves and settlements are consistent with exposures. Qualifications Bachelor's degree from an accredited university or two or more insurance industry designations or four additional years of related experience beyond the minimum experience required above may be substituted in lieu of a degree. 5 to 10 years of work experience at an insurance company and/or insurance claims loss adjustment service provider. 7 years minimal experience managing multi-line claims teams and processes supporting Commercial accounts. Adjuster licensing in all applicable states. Demonstrated ability to effectively lead Commercial Claim teams. Ability to develop and manage individual and team priorities with minimal supervision and direction. Commitment to continuous improvement through identification of opportunities in claim handling and underlying process improvement. Exceptional communication (written and verbal), influencing, evaluation, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines. Strong time management and organizational skills. Ability to work well in a team environment. Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint, and Word. Ability to analyze data utilizing tools such as Power BI or similar applications. Willing and able to travel 10%. #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. $111,240 - $140,100/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.

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Overview As a Claims Manager within the Arch Insurance Claims organization, you will be responsible for leading a team of Claims Examiners with varying levels of experience in the Direct Claims Resolution Unit ("DRC"). DRC handles a mixed caseload of Commercial Excess and Primary General Liability, Employment Practices Liability, Healthcare, Property, Professional Liability, Cyber, Surety, and Executive Assurance claims. This role reports to the AVP, Claims Shared Services. Primary Responsibilities, specific duties include but not limited to the below: * Directly manage a team of Claim Examiners. * Provide claim authority and guidance as necessary on specific claims. * Provide monthly and quarterly (or as needed) reports . * Ensure adjusting staff are compliant with current regulatory requirements. * Coordinate training for staff on relevant technical claim handling issues. * Collaborate with claim management, legal, and other claim product teams to develop strategies and business plans to reduce claim cost/expenses. * Seek guidance from claim leadership on issues that will have an impact on the Company. * Oversight of Claims Examiners to ensure all claims are handled within authority limits, and in line with Arch Claims procedures and guidelines. * Assist with driving the achievement of financial targets and ensure claims reserves and settlements are consistent with exposures. Qualifications * Bachelor's degree from an accredited university or two or more insurance industry designations or four additional years of related experience beyond the minimum experience required above may be substituted in lieu of a degree. * 5 to 10 years of work experience at an insurance company and/or insurance claims loss adjustment service provider. * 7 years minimal experience managing multi-line claims teams and processes supporting Commercial accounts. * Adjuster licensing in all applicable states. * Demonstrated ability to effectively lead Commercial Claim teams. * Ability to develop and manage individual and team priorities with minimal supervision and direction. * Commitment to continuous improvement through identification of opportunities in claim handling and underlying process improvement. * Exceptional communication (written and verbal), influencing, evaluation, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines. * Strong time management and organizational skills. * Ability to work well in a team environment. * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint, and Word. * Ability to analyze data utilizing tools such as Power BI or similar applications. * Willing and able to travel 10%. #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. $111,240 - $140,100/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.

Job Description- National Insurance Carrier is looking for an experienced EPL Claims Manager that is currently managing a team. Prior experience in EPLI & professional liability claims is preferred but not mandatory. Will need a minimum of 5 to 7 years experience in EPL and or professional liability claims. JD preferred with good interpersonal skills. Call for additional details.

Job Description Job Title: Remote Claims Specialist Hourly Pay: $22 -$27/hour We are looking for a skilled Claims Specialist to join our work-from-home team. In this role, you will assist in processing and reviewing insurance claims, ensuring all necessary information is gathered, and helping resolve claims efficiently. If you have strong attention to detail and enjoy supporting customers through the claims process, this is a great opportunity for you. Key Responsibilities: Assist in processing insurance claims, ensuring accuracy and timely resolution Review claims documentation, including reports, medical records, and other evidence Communicate with claimants, insurance adjusters, and third parties to gather information Help resolve disputes or issues with claims and escalate when necessary Maintain detailed records of claims progress and updates Ensure compliance with industry regulations and internal policies Provide excellent customer service and answer inquiries related to claims Qualifications: Experience in insurance, claims handling, or a related field Strong attention to detail and organizational skills Excellent communication and customer service abilities Ability to handle multiple claims and prioritize effectively in a remote environment Familiarity with insurance policies and claims procedures is a plus Must have reliable internet and a quiet, dedicated workspace Perks & Benefits: 100% remote work flexibility Competitive hourly pay: $22 - $27 Paid training and professional development opportunities Flexible work hours, including evening and weekend options Opportunities for career growth in the insurance industry A supportive and team-oriented work environment

The Voluntary Benefits Claims Examiner will support a large Group Insurance Business contract is responsible for the calculation of Voluntary Benefits across limited products according to Plan Provisions. Voluntary Benefits can include wellness, hospital indemnity, accident and critical illness products. This position requires the knowledge and understanding of Voluntary Benefits policies and procedures with a medical terminology background and ability to read medical records outside of ICD's, CPTs and HCPC to appropriately calculate the benefits due. You will be expected to follow through timely on claim processing, utilize judgment, and assess risk when rendering claim decisions. Able to communicate with various constituents with limited guidance and learn and transact using the client s systems. Expected to communicate clearly concisely to influence return to work, discuss terms of the certificate, and the basis of payment nonpayment. Key Responsibilities: + Document all claim information including phone calls and correspondence. + Utilize effective communication to obtain information both verbally and in writing and provide information to the claimant and employer. + Ability to read multiple pages of medical records to confirm benefits available to the member. + Ability to apply plan provisions understand the needs of the clients. + Expected to adhere to client Service Level Agreements and department s product s key performance requirements and any reporting. + Able to utilize strong organizational skills to manage multiple priorities while working under tight time constraints, possess the ability to work through ambiguity, and work effectively with various vendors with strong interpersonal skills. + Willing to support special internal functional projects and ad hoc requests as required. + Able to work cohesively with Subject Matter experts to support the day to day tasks, able to anticipate, identify, and resolve complex issues problems. + Able to communicate risks issues to supervisor and help with the resolution, as needed. + Provide exceptional customer service either over the phone or through email. + Able to provide leadership updates progress reports on training curriculum. + Utilize tools independently and accurately to identify work to be completed. + Professional and detailed verbal skills for outbound calls to obtain medical records or claim details to gather data to work claim to completion. Basic Qualifications: + Minimum of 6 months experience in Medical Insurance Claims Processing + Minimum of 1 year experience in a contact center/call center. Preferred Qualifications: + Group Life/Disability/ Voluntary Claims experience + Bachelor s Degree + NY Adjustor License + Strong mathematical skills Professional Skills: + Proficiency in Windows environment, including Word and Excel + Medical terminology knowledge + Strong written and verbal communications required + Detailed oriented with strong time management skills Job Requirement: Schedule flexibility to work a schedule from 7 am to 7 pm CST. Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Illinois, Maryland, Minnesota, New Jersey, New York or Washington as set forth below.The application window for this job will remain open until at least 05/13/2025. However, if this date has passed and this role is still posted, please note we are still accepting applications. Information on benefits is here. (************************************************************ Role Location Hourly Salary Range California $19.71 to $38.51 Colorado $19.71 to $33.27 District of Columbia $21.01 to $35.43 Illinois $18.27 to $33.27 Minnesota $19.71 to $33.27 Maryland $19.71 to $33.27 New York/New Jersey $18.27 to $38.51 Washington $21.01 to $35.43 What We Believe We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment. Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities. Read more here (*********************************************************************** Equal Employment Opportunity Statement Accenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law. Accenture is committed to providing veteran employment opportunities to our service men and women. For details, view a copy of the Accenture Equal Employment Opportunity and Affirmative Action Policy Statement (********************************************************************************************************************************************** . Requesting An Accommodation Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired. If you would like to be considered for employment opportunities with Accenture and have accommodation needs for a disability or religious observance, please call us toll free at ****************, send us an email (************************************************* or speak with your recruiter. Other Employment Statements Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States. Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration. Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.

What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Job Responsibilities Confirms coverage of claims by reviewing policies and documents submitted in support of claims. Ability to draft basic coverage position letters under a manager's supervision. Ability to draft acknowledgment letters in response to new notices. Conducts, coordinates, and directs investigation into loss facts and extent of damages. Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. Sets reserves within authority or makes claim recommendations concerning reserve changes to manager. Negotiates and settles claims either directly or indirectly. Prepares reports by collecting and summarizing information. Provides excellent and professional customer service. Participates in special projects or assists other team members as requested. US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The national average salary for the Associate Claims Examiner is $23.64 - $30.62 with 10% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose ‘Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.

This is your opportunity to join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry. At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process. Job Description AXIS is seeking a Claims Specialist - Management Liability to join our North America Claims team. The selected candidate will work closely with colleagues across AXIS Insurance including North American Claims and International Claims and the Directors & Officers (D&O) and Financial Institutions (FI) Business Units to develop and drive an industry leading claims offering and strategy. This role will be responsible for: * Handling and managing a wide variety of Management Liability Claims under limited supervision, including: Public D&O, Private D&O, Bankers Professional Liability (BPL), Investment Advisors, Private Equity, and Insurance Company Professional Liability (ICPL). Experience with Transactional Liability claims including Representations and Warranties, Judgment Preservation & Contingent Risk is a plus. * Investigation, analysis and evaluation of coverage, liability and damages, within best practices and maintain appropriate documentation * Reviewing Management Liability claims to determine the nature of loss, coverage provided, and scope of claim and to guide strategic direction regarding settlement/disposition of claims * Developing and maintaining relationships with internal and external partners * Escalating coverage issues and recommending outside coverage counsel assignments for approval, where warranted * Formulating claims and litigation strategies, assigning, directing, and managing outside counsel * Evaluate full pending of claims in connection with the posting and maintaining of accurate reserves * Managing costs, including use of coverage counsel and litigation costs as well as collaborating and working with the Litigation Management and Vendor Management teams ensuring cost management and the development and enhancement of panel counsel * Maintain and develop relationships with senior executives, brokers, reinsurers, actuaries, underwriters, insureds, and auditors (both external and internal) * Supporting underwriting inquiries and information requests and drafting, reporting claim trends, data analysis, and risk assessments * Leading and participating in presentations and discussions with Underwriters and Insureds on large losses and claim trends * Participating in claim audits * Participate in special projects and department initiatives. * Other duties as assigned Qualifications: * Juris Doctorate preferred; Admitted to practice a plus * Minimum of 5 years of experience handling Management Liability claims * Required state claims adjuster licenses (or ability to obtain within 90 days of hiring) * Demonstrated ability to work effectively as part of a team and meet deadlines * Experience with KPIs and the "flow" associated with Management Liability claims. Excel skills and experience with Power BI a plus. KEY SKILLS & ABILITIES: * Comfort with evaluating high exposure and complex claims * Excellent oral and written communication skills with the ability to deal effectively with a wide range of stakeholders * Experience presenting to senior management and outside partners * Knowledge of claims and litigation management, dispute resolution processes, and trials and appeals as well as excellent analytical, investigative, and negotiating skills * Travel is associated with this role (off-site meetings, court proceedings, mediations)

NJM is seeking a Workers' Compensation (WC) Claims Specialist (I/II/Sr.). This is a full-time position and offers a hybrid schedule after training with a required Tuesday, Thursday and another day in our West Trenton office. The WC 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 WC Claims Specialist will work with and communicate to all internal and external stakeholders, including: NJM policyholders, injured workers, medical providers, the NJM Medical Claims Services Department, the NJM Special Investigation Unit, the NJM WC Legal Staff, and other departments within NJM, as well as outside defense counsel and vendors. At NJM, our WC Claims Department empowers our employees to focus on delivering guidance and empathy to our customers because the claims experience is both emotional and memorable. As a department driven by service and customer advocacy, we are committed to providing transparent, empathetic guidance and collaborative engagement during the life of a claim. The WC Claims Department takes pride in being a key component in the growth and success of our policyholders' business operations. To meet these expectations, WC Claims Specialists are supported by a dedicated call center who can field calls for them and other specialized units who are responsible for setting reserves, making permanency payments, and following through on subrogation so they can dedicate the time needed to manage claims. Many of our staff are long tenured with a focus on building relationships, not only with our customers, but with each other providing for a positive and nurturing work environment. Hours: Monday to Friday 8:00AM- 4:15PM (Hours can vary depending on start time). Responsibilities: 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 improve outcomes for all parties Determine compensability and coverage issues by gathering medical and factual evidence Administer the delivery of timely, appropriate, and accurate benefits Evaluate the claim for potential fraud indicators and escalates the file to SIU, as appropriate Recognize and investigate subrogation opportunity and refer to NJM subrogation staff 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 Build rapport with policyholders, conduct on-site investigations when necessary, and educate policyholders on NJM 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 Recommend process improvement where applicable to best improve the department efficiency, work product, and service commitment to interested parties 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 knowledge of medical terminology and WC regulations for PA, CT, MD and/or DE claims. 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 medical terminology and WC regulations for PA, CT, MD and/or DE claims. 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 medical terminology and WC regulations for PA, CT, MD and/or DE claims. Knowledge of and/or experience working 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 Microsoft Office tools including Word and Outlook Licensed in CT and/or DE to adjust WC claims or have the ability to obtain these licenses within 90 days. Ability to travel for business purposes, approximately less than 10% Preferred: Associate or bachelor's degree AIC/CPCU or other applicable insurance designations Experience using Guidewire Claim Center, OnBase and additional Microsoft Office tools including Teams, Excel and PowerPoint Salary: The position can be filled at a I, II, or Sr. level. Salary is commensurate with experience and credentials. Level I starting rate is $57,286.45+ annually based on experience and credentials Level II starting rate is $65,890.50+ annually based on experience and credentials Sr Level starting rate is $79,129.05+ 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! Compensation: Salary is commensurate with experience and credentials. Pay Range: $57,286-$72,208 Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses. 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.

Overview Claim Clerk - In Office | Wall Township, NJ $18-$20/hr | M-F, 8:30 AM - 4:30 PM | 37.5 Hours/Week Build your career with purpose. Join a supportive team at CCMSI as a Claim Clerk in our Wall Township, NJ office. This fully in-office role is ideal for someone who thrives in a structured setting and enjoys supporting others through detailed administrative work. If you have strong communication skills, enjoy organization, and want to grow in a long-term claims career, this is a great entry point. Job Summary The Claim Clerk is responsible for a variety of clerical and administrative tasks that support our claims team. From filing and document organization to handling phone calls and backing up reception, your work will help ensure claims are processed accurately and efficiently. Responsibilities Match and sort incoming claim-related mail Follow up on bills and assist with file management Set up new claim files and support team instructions Back up receptionist duties when needed Enter summaries of correspondence and medical records into claim logs Retrieve, re-file, and maintain claim files in storage Photocopy and route claim documents Return provider or client calls as directed Provide general administrative support to assigned claims team Ensure timely task completion in accordance with CCMSI's service standards Qualifications Required Qualifications High School diploma or equivalent Strong written and verbal communication skills Detail-oriented with strong organizational abilities Comfortable working independently with minimal supervision Proficiency in Microsoft Office, including Word, Excel, and Teams Reliable, predictable attendance during scheduled hours Ability to sit or stand for long periods and lift up to 15 lbs occasionally Nice to Have Previous experience in an administrative or clerical role Familiarity with claims, insurance, or medical terminology Performance Metrics Timely and accurate completion of assigned tasks and clerical support Adherence to diary/task schedules and documentation standards Internal feedback and annual performance evaluation Growth Potential This role offers future opportunities for advancement within CCMSI's claims operations, including paths to become a Claim Assistant or Medical Only Claim Representative. What We Offer Four weeks of paid time off in your first year, plus 10 paid holidays Comprehensive benefits: Medical, Dental, Vision, Life Insurance, Critical Illness, Short & Long-Term Disability Employer-funded ESOP and 401K plan with company match Structured career development programs and internal promotion pathways A supportive in-office environment that values teamwork and employee growth Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Act with integrity Deliver service with passion and accountability Embrace collaboration and change Seek better ways to serve Build up others through respect, trust, and communication Lead by example-no matter their title We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #InOffice #OfficeLife #AdminAssistant #ClaimsCareer #CareerGrowth #IND456 #LI-InOffice We can recommend jobs specifically for you! Click here to get started.