Certification Specialist
Claim processor job in Newark, NJ
Job Title: Certification Analyst
Duration: 06+ Months
Pay rate: $33.63/Hr. on W2 without benefits
Client: New Jersey - Transit-procurement
Job Description:
The Certification Analyst will be responsible for reviewing DBE re-evaluation applications, which include but are not limited to Personal Narratives (PN), Personal Net Worth Statements (PNW), Declarations of Eligibility (DOE), or Gross Receipts submitted by firms seeking certification under the current DBE federal program. This position requires advanced analytical skills to determine whether applicant submissions meet regulatory standards, demonstrate eligibility, and align with program requirements. The Specialist ensures fairness, accuracy, and consistency in certification decisions while upholding compliance with governing regulations. In addition, this role supports contract compliance functions and contributes to OBD special projects and initiatives as assigned.
Key Responsibilities
Narrative Review & Analysis
Read and critically evaluate Personal Narratives and Declaration of Eligibility (DOE) submitted with certification applications.
Review Personal Net Worth, Gross Receipts, or any other applicable financial statement to make sure applicants meet the economic standards as required by program regulations.
Identify gaps, inconsistencies, or insufficient evidence in applicant submissions.
Compliance & Decision-Making
Apply federal and state certification criteria (e.g., 49 CFR Part 26 for DBE programs).
Ensure decisions align with current regulatory changes, including IFR updates requiring individualized showings of disadvantage.
Document findings and provide clear recommendations for approval, denial, or request for additional information.
Communication
Communicate with applicants regarding deficiencies or clarifications needed in their narratives.
Collaborate with certification officers, legal staff, and program managers to ensure consistent application of standards.
Maintain accurate records of narrative reviews and decisions.
Prepare summary reports highlighting trends, common deficiencies, and recommendations for process improvement.
Qualifications
Bachelor's degree in Public Administration, Law, Business, or related field.
Demonstrated analytical and critical thinking skills.
Strong knowledge of certification programs (DBE/ACDBE, MWBE, SBE) and regulatory frameworks.
Excellent written communication skills for documenting findings and crafting clear, concise recommendations.
Experience in compliance, investigations, or regulatory review preferred.
Experience in Compliance Management System - (CMS - B2G)
Complex Claims Examiner -FAIRCO
Claim processor job in New York, NY
For a description, see PDF at: ************ transre. com/wp-content/uploads/2025/10/FAIRCO-Complex-Claims-Examiner.
pdf
Claims Examiner
Claim processor job in Jersey City, NJ
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠.
Position Summary
The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence.
Responsibilities:
* Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level
* Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution
* Review and analyze supporting damage documentation
* Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions
* Establish appropriate loss and expense reserves with documented rationale
* Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines
Experience & Qualifications
* Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word
* Knowledge of ImageRight preferred
* Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
* Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions
* Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines
* Ability to work well independently and in a team environment
* Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date.
Education
* Bachelor's degree preferred
* 3-5 years' experience handling the process of commercial insurance claims
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$71,900 - $97,110/year
* Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
* Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
14400 Arch Insurance Group Inc.
Auto-ApplyClaims Examiner
Claim processor job in New York, NY
Job Description
Jones Jones LLC is a trusted leader in workers' compensation defense, claims management, and regulatory compliance. With decades of industry experience, we proudly serve clients through our affiliated entities - NYTIC, Emerald, Mediation Resolution Management, and Medical Management Group - offering innovative solutions, collaborative teamwork, and unwavering professionalism. Our firm values growth, integrity, and excellence across every level of our organization.
We are seeking an experienced Claims Examiner who is interested in growing and expanding their expertise across multiple entities, including NYTIC, Emerald, Mediation Resolution Management and Medical Management Group. This unique cross-functional role offers exposure to complex claims, compliance, and ADR operation. This role is perfect for a skilled examiner seeking to broaden scope, strengthen leadership, and grow within a premier workers' compensation firm.
The Firm is located at 5 Hanover Square, New York, NY and this is a hybrid position.
Essential Functions
1. Claims Adjusting Work (NYTIC / Emerald):
Perform intake and coverage verification via WCB employer coverage search
Initiate three-point contact (employer/clamant/provider) within 24 hours
Conduct compensability analysis and develop action plans
Ensure timely filings: employer first report, EDI FROI/SROI via Emerald, PH-16.2, and C-240 wage statement
Calculate AWW and benefit rates; set and review reserves at key milestones
Monitor treatment against NY Medical Treatment Guidelines; manage MG-2 variance requests and C-8.1 objections
Route medical bills to bill review and ensure fee schedule compliance
Prepare for hearings and maintain eCase updates
Evaluate resolution paths (SLU, LWEC, Section 32); manage subrogation and third-party notices
2. Licensing & Compliance (Jones Jones):
Collaborate with the Compliance team on licensing forms and regulatory filings
Review TPA scorecards and ensure compliance with WCB standards
Track and invoice licensing fees and renewals
Support examiner training and respond to licensing-related inquiries
3. ADR (MRM):
Manage intake, eligibility, and notices under the collectively bargained ADR program
Coordinate and schedule mediations
Draft case summaries and settlement proposals
Ensure adherence to Medical Network protocols and document variances
Prepare and route settlement paperwork, including Section 32 agreements
Maintain dashboards of ADR cycle times and outcomes for annual reporting
Obtain loss runs from wrap-up sponsors
4. MMG
Evaluate Independent Medical Examination (IME) reports for accuracy and compliance
Assist with administrative tasks such as schedule coordination and provider panel management
Competencies
Excellent and professional verbal and written communication skills
Strong understanding of workers' compensation best practices
Exceptional organizational skills and attention to detail
Excellent time management skills with a proven ability to meet deadlines
Strong analytical and problem-solving skills
Ability to perform well in a fast-paced, dynamic environment
Ability to maintain confidentiality and exercise discretion and sound judgment
Proficient with Microsoft Office Suite or related software
Qualifications
Bachelor's degree in business administration or related field
Active Independent Adjuster License (required)
2- 5 years of claims management experience
Apply today to join a firm with over a century of success and a future focused on innovation. Jones Jones LLC is an equal employment opportunity employer.
Claims Processor
Claim processor job in Commack, NY
Required Qualifications (as evidenced by an attached resume): Associates degree (foreign equivalent or higher). In lieu of degree, two (2) years of full-time experience in a medical setting may be considered. Four (4) years of full-time experience working in a medical and/or office setting. Previous medical claims processing experience.
Preferred Qualifications:
Medical coding certification. Knowledge of medical terminology, ICD-10 and CPT coding. Experience with Electronic Medical Records (EMR). Experience with an electronic billing system(s). Experience with the Patient Keeper billing system. Knowledge of IDX (scheduling system). Familiarity with World Trade Center Health Program (WTCHP). Familiarity with HIPAA. Proficiency with Word and Excel.
Brief Description of Duties:
The successful candidate must possess excellent organizational and communication skills. S/he should have a strong sense of responsibility and initiative, use sound judgment in making decisions, and have the ability to work independently under minimal supervision. S/he will be responsible for assisting the Claims Manager with the following duties:
Duties:
Verifying accuracy, completeness and compliance with WTCHP guidelines. Validating and releasing both internal and external claims.
Research claims for payment in the WTCHP InterChart and EMR. Confirmed the patient was WTC-referred and services were authorized.
Confirm receipt of office notes and/or test results, and other criteria as determined by the program such as certifications, correct coding, operative reports, etc.
Facilitate resolution of claims received that are not complete and/or do not comply with the Program guidelines. Deny claims when appropriate.
Assist in the resolution of billing issues, i.e., WTCHP program billed in error, program billed as secondary insurance, out of network providers billed in error.
Ensure that vendors and providers are in the WTCHP network, when necessary. Work with Claims Manager to have vendors and/or providers added to the network.
Assist in the education of program guidelines and claims processes to external providers.
Assist in the maintenance of the comprehensive claims process, i.e. through input of suggestions for quality improvement or revisions to best practices.
Other duties or projects as assigned.
Special notes:
The Research Foundation of SUNY is a private educational corporation. Employment is subject to the Research Foundation policies and procedures, sponsor guidelines and the availability of funding. FLSA Non-Exempt position, eligible for the overtime provisions of the FLSA.
**The incumbent must be willing to work and travel between the Nassau and Commack clinic locations. Occasional Evenings and Saturdays will be required.
For this position, we are unable to sponsor candidates for work visas.
Resume/CV and cover letter should be included with the online application.
Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
If you need a disability-related accommodation, please call the university Office of Equity and Access (OEA) at ************** or visit OEA.
In accordance with the Title II Crime Awareness and Security Act
a
copy of our crime statistics can be viewed
here
.
Visit our WHY WORK HERE page to learn about the total rewards we offer.
SUNY Research Foundation\: A Great Place to Work.
The starting salary range (or hiring range) to be offered for this position is noted below, it represents SBU's good faith and reasonable estimate of the range of possible compensation at the time of posting.
Auto-ApplyComplex Claims Examiner
Claim processor job in New York, NY
About Us
Since 1977 we have delivered first class solutions to insurers worldwide, by combining global reach with local decision making. We have built customer & broker relationships on years of trust, experience and execution. Through our people, our products and our partnerships, we deliver the capacity and expertise necessary to contribute to the sustainable growth of prosperous communities worldwide. To do so, our colleagues work with:
Integrity Work honestly, to enhance TransRe's reputation
Respect Value all colleagues. Collaborate actively.
Performance We reward excellence. Be accountable, manage risk and deliver TransRe's strengths
Entrepreneurship Seize opportunities. Innovate for and with customers.
Customer Focus Anticipate their priorities. Exceed their expectations.
We have the following job opportunity in our New York City office:
Description
We seek an experienced claims professional to join our growing FAIRCO team in our New York City office. FAIRCO is a subsidiary of TransRe Holdings, a Berkshire Hathaway company. As a member of FAIRCO, the Complex Claims Examiner will be responsible for adjusting Professional & Management Liability claims, with opportunities for experiences with other FAIRCO programs. Responsibilities will include but not be limited to:
Managing and adjusting primary and excess Professional & Management Liability claims, including private and public company, Directors and Officers, lawyers liability, accountants liability, financial institutions, cyber, employment practices and miscellaneous professional liability.
Proactively handling claims throughout the entire claim lifecycle from inception to resolution.
Analyzing policy coverage and drafting coverage analyses based on contract terms and claim details.
Evaluating liability and damages to determine the level of exposure to the insured and the policy.
Directing and closely monitoring assignments to defense counsel and experts in accordance with relevant guidelines.
Collaborating with underwriters, brokers, program partners, and insureds to ensure seamless claims resolution.
Traveling to and attending claims mediations, as required.
Developing and implementing claims handling strategies to mitigate risk and reduce claim expenses.
Requirements
The ideal candidate will possess the following knowledge, skills and abilities:
Extensive experience litigating or handling issues pertaining to complex Professional & Management Liability issues, with a focus on Directors and Officers coverage.
Experience leading mediations for Professional & Management Liability claims.
Experience evaluating coverage under various types of policies, drafting coverage correspondence, and participating in claims investigations.
Track record of effectively managing defense counsel and legal spend, assessing liability and financial exposure, and effectively negotiating cost effective, good faith claims resolutions.
Juris Doctorate preferred.
Willingness to travel up to 25% of the time for mediations, industry conferences, and client meetings.
Possession of, or willingness to obtain, a New York and other state adjuster's licenses.
Work Schedule
TransRe is supportive of an agile work schedule, which may differ based on individual roles, your local office's practices and preferences, marketplace trends, and TransRe's business objectives. This position is eligible for a hybrid work schedule with 3 days in the office per week, and 2 days remote.
Compensation
In addition to base salary, for this position, TransRe offers a comprehensive benefits package, paid time off, and incentive pay opportunity. The anticipated annual base salary range in New York for this position, exclusive of benefits, paid time off, and incentive pay opportunity is $140,000 - $180,000. This range is an estimate, and the actual base salary offered for this position will be determined based on certain factors, including the applicant's specific skill set and level of experience.
We are an Equal Opportunity Employer (EOE) and we support diversity in the workforce.
Auto-ApplyClaims Processor
Claim processor job in Commack, NY
Claims Processor Required Qualifications (as evidenced by an attached resume):Associates degree (foreign equivalent or higher). In lieu of degree, two (2) years of full-time experience in a medical setting may be considered. Four (4) years of full-time experience working in a medical and/or office setting.
Previous medical claims processing experience.
Preferred Qualifications: Medical coding certification.
Knowledge of medical terminology, ICD-10 and CPT coding.
Experience with Electronic Medical Records (EMR).
Experience with an electronic billing system(s).
Experience with the Patient Keeper billing system.
Knowledge of IDX (scheduling system).
Familiarity with World Trade Center Health Program (WTCHP).
Familiarity with HIPAA.
Proficiency with Word and Excel.
Brief Description of Duties:The successful candidate must possess excellent organizational and communication skills.
S/he should have a strong sense of responsibility and initiative, use sound judgment in making decisions, and have the ability to work independently under minimal supervision.
S/he will be responsible for assisting the Claims Manager with the following duties: Duties:Verifying accuracy, completeness and compliance with WTCHP guidelines.
Validating and releasing both internal and external claims.
Research claims for payment in the WTCHP InterChart and EMR.
Confirmed the patient was WTC-referred and services were authorized.
Confirm receipt of office notes and/or test results, and other criteria as determined by the program such as certifications, correct coding, operative reports, etc.
Facilitate resolution of claims received that are not complete and/or do not comply with the Program guidelines.
Deny claims when appropriate.
Assist in the resolution of billing issues, i.
e.
, WTCHP program billed in error, program billed as secondary insurance, out of network providers billed in error.
Ensure that vendors and providers are in the WTCHP network, when necessary.
Work with Claims Manager to have vendors and/or providers added to the network.
Assist in the education of program guidelines and claims processes to external providers.
Assist in the maintenance of the comprehensive claims process, i.
e.
through input of suggestions for quality improvement or revisions to best practices.
Other duties or projects as assigned.
Special notes:The Research Foundation of SUNY is a private educational corporation.
Employment is subject to the Research Foundation policies and procedures, sponsor guidelines and the availability of funding.
FLSA Non-Exempt position, eligible for the overtime provisions of the FLSA.
**The incumbent must be willing to work and travel between the Nassau and Commack clinic locations.
Occasional Evenings and Saturdays will be required.
For this position, we are unable to sponsor candidates for work visas.
Resume/CV and cover letter should be included with the online application.
Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
If you need a disability-related accommodation, please call the university Office of Equity and Access (OEA) at ************** or visit OEA.
In accordance with the Title II Crime Awareness and Security Act a copy of our crime statistics can be viewed here.
Visit our WHY WORK HERE page to learn about the total rewards we offer.
SUNY Research Foundation: A Great Place to Work.
The starting salary range (or hiring range) to be offered for this position is noted below, it represents SBU's good faith and reasonable estimate of the range of possible compensation at the time of posting.
Job Number: 2504206Official Job Title: Clerical Specialist IIJob Field: Clerical/SecretarialPrimary Location: US-NY-CommackDepartment/Hiring Area: Dept of Med - WTCHPSchedule: Full-time Shift :Day Shift Shift Hours: 8:00am-4:00pm Posting Start Date: Dec 1, 2025Posting End Date: Dec 16, 2025, 4:59:00 AMSalary:$50,000-$56,000Appointment Type: RegularSalary Grade:N7 SBU Area:The Research Foundation for The State University of New York at Stony Brook
Auto-ApplyClaims Processor
Claim processor job in Commack, NY
Claims Processor Required Qualifications (as evidenced by an attached resume):Associates degree (foreign equivalent or higher). In lieu of degree, two (2) years of full-time experience in a medical setting may be considered. Four (4) years of full-time experience working in a medical and/or office setting.
Previous medical claims processing experience.
Preferred Qualifications: Medical coding certification.
Knowledge of medical terminology, ICD-10 and CPT coding.
Experience with Electronic Medical Records (EMR).
Experience with an electronic billing system(s).
Experience with the Patient Keeper billing system.
Knowledge of IDX (scheduling system).
Familiarity with World Trade Center Health Program (WTCHP).
Familiarity with HIPAA.
Proficiency with Word and Excel.
Brief Description of Duties:The successful candidate must possess excellent organizational and communication skills.
S/he should have a strong sense of responsibility and initiative, use sound judgment in making decisions, and have the ability to work independently under minimal supervision.
S/he will be responsible for assisting the Claims Manager with the following duties: Duties:Verifying accuracy, completeness and compliance with WTCHP guidelines.
Validating and releasing both internal and external claims.
Research claims for payment in the WTCHP InterChart and EMR.
Confirmed the patient was WTC-referred and services were authorized.
Confirm receipt of office notes and/or test results, and other criteria as determined by the program such as certifications, correct coding, operative reports, etc.
Facilitate resolution of claims received that are not complete and/or do not comply with the Program guidelines.
Deny claims when appropriate.
Assist in the resolution of billing issues, i.
e.
, WTCHP program billed in error, program billed as secondary insurance, out of network providers billed in error.
Ensure that vendors and providers are in the WTCHP network, when necessary.
Work with Claims Manager to have vendors and/or providers added to the network.
Assist in the education of program guidelines and claims processes to external providers.
Assist in the maintenance of the comprehensive claims process, i.
e.
through input of suggestions for quality improvement or revisions to best practices.
Other duties or projects as assigned.
Special notes:The Research Foundation of SUNY is a private educational corporation.
Employment is subject to the Research Foundation policies and procedures, sponsor guidelines and the availability of funding.
FLSA Non-Exempt position, eligible for the overtime provisions of the FLSA.
**The incumbent must be willing to work and travel between the Nassau and Commack clinic locations.
Occasional Evenings and Saturdays will be required.
For this position, we are unable to sponsor candidates for work visas.
Resume/CV and cover letter should be included with the online application.
Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
If you need a disability-related accommodation, please call the university Office of Equity and Access (OEA) at ************** or visit OEA.
In accordance with the Title II Crime Awareness and Security Act a copy of our crime statistics can be viewed here.
Visit our WHY WORK HERE page to learn about the total rewards we offer.
SUNY Research Foundation: A Great Place to Work.
The starting salary range (or hiring range) to be offered for this position is noted below, it represents SBU's good faith and reasonable estimate of the range of possible compensation at the time of posting.
Job Number: 2504206Official Job Title: Clerical Specialist IIJob Field: Clerical/SecretarialPrimary Location: US-NY-CommackDepartment/Hiring Area: Dept of Med - WTCHPSchedule: Full-time Shift :Day Shift Shift Hours: 8:00am-4:00pm Posting Start Date: Dec 1, 2025Posting End Date: Dec 15, 2025, 11:59:00 PMSalary:$50,000-$56,000Appointment Type: RegularSalary Grade:N7 SBU Area:The Research Foundation for The State University of New York at Stony Brook
Auto-ApplyTrucking Claims Specialist
Claim processor job in New York, NY
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
* Competitive compensation
* Healthcare benefits package that begins on first day of employment
* 401K retirement plan with company match
* Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
* Up to 6 weeks of parental and bonding leave
* Hybrid work schedule (3 days in the office, 2 days from home)
* Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
* Tuition reimbursement after 6 months of employment
* Numerous opportunities for continued training and career advancement
* And much more!
Responsibilities
Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service.
Key Responsibilities
* Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures.
* Review and interpret policy language to determine coverage and consult with coverage counsel when needed.
* Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies.
* Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information.
* Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts.
* Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards.
* Participate in file reviews, team meetings, and ongoing training to support continuous learning.
Salary Range
$95,000.00-$145,000.00 USD
The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training.
Qualifications
* Minimum of 3 years of trucking industry experience.
* Experience with bodily injury and/or cargo exposures.
* Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices.
* Strong analytical and negotiation skills, with the ability to manage multiple priorities.
* Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism.
* Possession of applicable state adjuster licenses.
* Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
Auto-ApplyCommercial Auto Bodily Injury Claims Examiner
Claim processor job in New York, NY
Job DescriptionOur client is actively seeking a seasoned Commercial Auto Bodily Injury Claims Adjuster to join their growing NYC team. This person will be responsible for managing a portfolio of moderate to complex claims involving commercial auto exposures, often including litigated files. From first notice to final resolution, you'll drive the claims process with precision, ensuring timely outcomes and outstanding service. Key Responsibilities:
Conduct thorough investigations and evaluations of commercial auto bodily injury claims, exercising sound judgment within designated authority limits to ensure prompt and fair resolution.
Manage a caseload consisting of 100 - 110 Commercial Auto files with bodily injury exposures.
Collaborate with claimants, legal representatives, and other stakeholders to negotiate settlements, issue payments, and bring claims to closure effectively.
Maintain accurate documentation and prepare detailed claim status reports to support transparency and compliance throughout the claims lifecycle.
Requirements:
5 to 7+ years of experience handling Litigated Commercial Auto Bodily Injury claims.
Strong analytical thinking and attention to detail to assess coverage, liability, and damages accurately.
Excellent negotiation and communication skills, with the ability to manage complex interactions confidently.
Proficiency in modern claims management software and related technologies.
Active adjusters license, highly preferred.
Salary & Benefits:
Competitive base salary ranging from $95,000 to $110,000, depending on experience.
Comprehensive benefits package, including health, dental, and vision insurance.
Generous PTO and paid holidays.
Clear pathways for career advancement.
401(k) plan with competitive employer matching.
Claims Specialist - Management Liability
Claim processor job in New York, NY
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.
About the Team AXIS is a leading provider of specialty insurance and global reinsurance. The Management Liability team is an engaging team handling claims in a variety of financial lines. The strength of our team is grounded in our people and culture, encouraging collaboration, growth, and diversity. How does this role contribute to our collective success? The selected individual will collaborate with a team to investigate, analyze, and evaluate Third Party Liability claims, ensuring proper coverage determinations. Expertise will be developed in Directors & Officers or Financial Institutions units while engaging with complex insureds on significant and dynamic disputes. This role offers meaningful opportunities to contribute to impactful case resolutions within specialized insurance sectors. What Will You Do In This Role? Serving as a Claims Specialist focused on Management Liability Claims within AXIS' North America Claim team. Managing a diverse range of liability claims, including Public D&O, Private D&O, and Private Equity, and Insurance Company Professional Liability. Determining the appropriate valuation of complex claims, recommending settlement strategies, adhering to company policies, and collaborating with insureds, brokers, and partners effectively. Traveling to distinctive destinations to participate in mediations, observe trials, and strengthen relationships with vital AXIS partners. Escalating coverage concerns to internal teams and collaborating with external coverage attorneys when specific assignments necessitate their involvement. Developing claims and litigation strategies, delegating tasks, and overseeing the work of external legal advisors effectively. Assisting with underwriting inquiries while analyzing claim trends, conducting data analysis, and performing comprehensive risk assessments to support decision-making processes. Keeping precise records of claim activities and promptly updating systems with all relevant details ensuring accuracy and efficiency. About You We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals. What We're Looking For Seek candidates who bring unique perspectives and diverse skills to the team. Contribute actively to the success of a growing and dynamic team by bringing energy and a positive attitude. Hold a Juris Doctorate. Operate efficiently in settings with high visibility, shifting deadlines, and evolving expectations while staying focused and achieving outcomes. Demonstrate organizational abilities and solve problems effectively. Exhibit outstanding skill in verbal communication and written expression. Showcase skill as a litigator or litigation manager, well-versed in dispute resolution. Write coverage letters independently with precision and attention to detail, ensuring accuracy in all aspects of the work. Role Factors Travel is associated with this role. The role requires you to be in office 3 days per week and adhere to AXIS licensing requirements. What We Offer For this position, we currently expect to offer a base salary in the range of $73,000 - $146,000. Your salary offer will be based on an assessment of a variety of factors including your specific experience and work location. In addition, you will be offered competitive target incentive compensation, with awards based on overall corporate and individual performance. On top of this, you will be eligible for a comprehensive and competitive benefits package which includes medical plans for you and your family, health and wellness programs, retirement plans, tuition reimbursement, paid vacation, and much more. Where this role is based in the United States of America, this role is Exempt. About Axis 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. AXIS Persona AXIS Capital seeks professionals who thrive in a dynamic, high-performing environment grounded in humility and mutual respect. We employ those who exemplify our core values of People, Excellence, Decisiveness, and Stronger Together. We are a team characterized by integrity and self-discipline, striving for continuous improvement and driven to achieve ambitious results. Our focus is on hiring, developing, retaining, and rewarding individuals who excel in: Purposeful Action: Delivering top-tier work with a data-driven approach and operating at AXIS speed. Collaborative Decision-Making: Valuing input from all relevant groups and being open to debate. Able to leave their ego at the door and be committed to achieving results through teamwork, fully supporting decisions once made. Measuring Outcomes: Consistently evaluating performance against established expectations. The AXIS employee will cultivate a collaborative workplace atmosphere, fostering trust within the team. We believe in respectful challenges, presuming best intent, and building meaningful relationships with colleagues, customers, and the communities we serve. Joining our team means becoming part of a workplace where every individual's contributions are valued, and excellence is pursued with purpose and passion. Together, we elevate our standards, achieve ambitious results, and make a lasting impact on each other and those we serve
Auto-ApplyClaims Specialist
Claim processor job in New York, NY
Why Shiftsmart We're building the Amazon of labor. We're a labor platform pairing end-to-end workforce management technology with a rapidly growing global network of 5M flexible workers to create scalable labor solutions for the largest companies and government agencies in the world like Circle K, Pepsi, Walmart, Starbucks and more. Our unique business model fractionalizes jobs down to shifts and makes it easy for workers to work across multiple companies through a digital marketplace. We're one of the fastest-growing startups in the country. We've grown 2-3x each year since we started, paid over $130M in wages to hourly workers, and raised $120M+ from top-tier investors including D1 Capital & Imaginary Ventures…and we're only getting started.
Mission:
The mission of the Privacy and Compliance function is to ensure Shiftsmart processes and policies adhere to relevant legal and regulatory requirements and ensure positive & safe experiences for both users, clients, and company. You will be directly contributing in helping create and maintain a resource for both customers and users to assist with any privacy or legal related requests.
This role is based in New York City (HQ) with typically 4+ days in office
Outcomes:
This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.This position will evolve over time but some of your early responsibilities will include:
* Gather, organize, and analyze information related to incidents and escalated complaints.
* Support the creation of comprehensive written investigative reports based on gathered data.
* Perform initial analysis of all escalated incidents and complaints, considering factors such as location, type of task, and the nature of the issue.
* Coordinate closely with the Customer, Support, and Operations teams to compile relevant data, records, and other evidence necessary for investigative reports.
* Maintain a robust tracking system to monitor the outcomes of all escalations and investigated cases.
* Meet response time SLAs for communicating with partners, law enforcement contacts, and customer contacts.
Competencies:
* Experience: You have 1-2 years of experience in employee relations, as a claims analyst, or in an investigatory role with the potential, motivation and ambition to grow and thrive in a fast-paced environment.
* Communication: You have excellent communication skills and enjoy helping people feel heard, know how to ask the important questions, and analyze the relevant information into a report
* Results driven: Takes pride in & has a track record of hitting or exceeding targets; persists in accomplishing objectives despite obstacles or setbacks. You thrive in an environment where success is measured in metrics and improvement
* Collaboration: Ability to work closely with all areas of the company to be a problem solver. This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.
* Highly organized: You plan, organize and execute in a highly structured way & relish bringing formality to ambiguity, ruthlessly prioritize, and feel organization is second nature to you.
* Independent: Able to function with a high-level of autonomy once given a playbook.
Compensation philosophy
To provide greater transparency we share base salary ranges, which are based on role and level benchmarked against similar stage, high growth companies. Offers are determined based on multiple factors including skills, work experience, and relevant credentials.
In addition to competitive salaries and meaningful equity we offer the following benefits:
* Comprehensive healthcare coverage: We cover 100% of employee premiums for medical, dental, and vision care (60-75% for dependents)
* 401(k) match program: We match 100% on the first 3% of your contributions and 50% on the next 2% for a maximum match of 4%
* Generous, fully paid parental and family leave policies
* Pre-tax commuter benefits
* Collaborative office with fully stocked kitchen @ 1 World Trade in Manhattan
Equal opportunity employer
Shiftsmart is committed to creating a diverse environment and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Operating Principles @ Shiftsmart
Inspired by Leadership Principles @ Amazon
Execution Is Binary
We #GetShiftDone. We take immense pride in both the quality of our work and our relentless determination to deliver on our commitments. If we say we are going to do something, we do it.
We own the outcome with an unstoppable mindset through the finish line and are impatient to move the ball forward. This means we work really hard, execute with urgency, and ruthlessly challenge timelines for anything important. As a result, we do not defer responsibility to other teams or individuals. Instead, we take the problem as far as we can and only when needed ask others for help.
Each time a crisis or opportunity emerges we take the hill as one team, because we are allergic to the words "it can't be done".
Missionaries, Not Mercenaries
We before me. We believe in our mission to build a better world for workers. We understand why our work matters and take seriously how it impacts our customers and our partners. This belief permeates everything we do from the strategic to the mundane.
We are energetic, ambitious, and want to win. We constantly raise the standards for ourselves and everyone around us. We show up for our customers, our partners, and most importantly our teammates, and make every effort to build lasting relationships with each of them.
We do not measure success based on our titles or the size of our empires. This also means we put the needs of the business before the details of our job descriptions. Rather than fight for a bigger piece of the pie, we fight to grow the entire thing and recognize this is how to grow our careers too.
Inputs > Outcomes
We work really hard. Fundamentally changing how labor works is not easy. It often requires long days, late nights, and weekends to deliver on our commitments. We lean into this challenge.
We focus on the process. We think in terms of value chains and appreciate that a bad process with a good outcome is simply dumb luck.
We lead with data. We use facts, not fiction, to build narratives and make decisions. To do this we prepare written memos in advance and resist the urge to engage in endless water cooler what ifs, because we value the time and attention of our teammates.
We hire and develop the best. When we decide to hire a new team member, we do so because we believe they will increase the talent density on our team. We view ourselves as leverage maximizers rather than inconvenience reducers and strive to increase the output of everyone we interact with.
Honesty Over Harmony
We share the truth even when it is painful. We do not, however, share the truth callously to hurt people's feelings or make them look bad. We also assume positive intent. If someone is not delivering in a way that we need, we ask them and tell them before assuming the worst.
We embrace mutual feedback. As people leaders we care more about our team's growth and success than how much others like us. As individuals we seek, accept, and apply feedback. We do not give or take feedback personally because we understand it enables us to learn and grow.
We tell the truth to ourselves. We reject a pollyannaish view of our world. Instead if something isn't going well that we are responsible for, we call it out. And when someone calls out their own truth that may be less optimal, we don't punish them for it.
We have the meeting in the meeting. If something is broken or we disagree, we call it out and say something in the moment even if it feels uncomfortable to do so. This means that if something is broken, we do not just accept it and complain later.
Invent & Iterate
We are ********************* categorically reject the phrase "that is how it's always been done", and constantly discover new and better ways to do more with less. This means we are resourceful and often do things that don't scale, only to create ways to scale them later. We're builders.
We think BIG. At every level of the company, we embrace big, hairy, audacious, and transformative goals. We fear lack of progress and incremental thinking more than failing to deliver or falling short of an audacious goal. We believe courage means to try without fear and learn without ego.
We do not let perfect get in the way of better. When faced with the choice we prioritize delivering something, even if imperfect, over endless debate and alignment. We embrace good mistakes.
Claims Specialist
Claim processor job in New York, NY
We are seeking a highly skilled and detail-oriented Claims Specialist with expertise in handling No-Fault, Worker's Compensation and all other medical insurance claims. The ideal candidate must have 3+ years experience and will have a thorough understanding of regulatory requirements and processes associated with these types of claims, along with excellent communication and problem-solving skills. Must be available for employment Monday-Friday for 9a-5p employment.
Responsibilities:
Manage and process No-Fault insurance claims, including reviewing claim submission, verifying coverage, and ensuring compliance with regulatory guidelines.
Handle Worker's Compensation claims from initial filling through resolution, including investigating incidents, gathering relevant documentation, and coordinating with legal counsel as needed.
Conduct through investigation into claim validity, including medical records, and other relevant documentation.
Communicate effectively with claimants, insurance adjuster, and other stakeholders to facilitate the claims process and resolve issues in a timely manner.
Maintain accurate and up-to-date claim files and documentation, ensuring compliance with internal policies and regulatory requirements.
Obtain and verify insurance information for patients, including primary and secondary coverage, policy numbers, group numbers, and policy holder information.
Liase with insurance companies and third-party payers to confirm coverage details, policy benefits, and pre-authorization requirements.
Collaborate with medicalbillingteam to ensure accurate timely submission of claims and pre-authorizations.
Resolve insurance related issues and discrepancies, including denials and rejections, through effective communication and follow-up with insurance carriers.
Educate patients on insurance benefits, coverage limitations, and financial responsibilities, providing assistance with insurance inquiries and concerns.
Verify patient insurance coverage and eligibility.
Assist patients with insurance-related inquiries, explaining coverage details, copays, deductibles, and out-of-pocket expenses.
Prepare and submit insurance claims and billing statements.
Maintain confidentiality of patient information and ensure compliance with HIPAA regulations in all administrative activities.
Qualifications:
3+ years experience with medical insurance claims
Thorough understanding of regulatory requirements and processes
Excellent communication and problem-solving skills
Transactional Risk Claims Specialist
Claim processor job in New York, NY
Who are we?
Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries.
People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden.
Classification: Exempt/Full-time
Reports to: Head of Claims for Transactional Risk
Travel: 0-15%
Salary: $150,000.00-$215,000.00
Role overview
DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team.
The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice.
This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time.
Role responsibilities
Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion.
Assist with entering claim data into operational systems.
Assist with quality control and performance management, to ensure high-quality claim handling.
Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers.
Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices.
Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners.
Perform other duties as assigned.
Key requirements
Bachelor's degree required and law degree preferred.
Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable.
Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions.
Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
Ability to manage multiple competing priorities.
Ability to adapt to evolving regulatory and legal environments.
Complete assigned tasks correctly, on time and able to learn quickly.
Self-motivated and demonstrating attention to detail.
Be able to work independently for extended periods.
Excellent written and verbal communication skills as well as general business understanding.
Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment.
If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team.
What do we offer in return?
A career that you define.
Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more.
What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community.
Our culture: people first
Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world.
The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key.
Diversity and inclusion
At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances.
What do we offer in return?
A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us:
Our successes have all come from someone brave enough to try something new
We support each other in the small everyday moments and the bigger challenges
We are determined to make a positive difference at work and beyond
Reasonable adjustments
We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*.
If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require.
*Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more.
Permanent
Auto-ApplyClaims Specialist
Claim processor job in New York, NY
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.
****************************
Transactional Risk Claims Specialist
Claim processor job in New York, NY
Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries.
People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden.
* Classification: Exempt/Full-time
* Reports to: Head of Claims for Transactional Risk
* Travel: 0-15%
* Salary: $150,000.00-$215,000.00
Role overview
DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team.
The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice.
This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time.
Role responsibilities
* Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion.
* Assist with entering claim data into operational systems.
* Assist with quality control and performance management, to ensure high-quality claim handling.
* Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers.
* Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices.
* Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners.
* Perform other duties as assigned.
Key requirements
* Bachelor's degree required and law degree preferred.
* Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable.
* Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions.
* Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives.
* Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
* Ability to manage multiple competing priorities.
* Ability to adapt to evolving regulatory and legal environments.
* Complete assigned tasks correctly, on time and able to learn quickly.
* Self-motivated and demonstrating attention to detail.
* Be able to work independently for extended periods.
* Excellent written and verbal communication skills as well as general business understanding.
* Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment.
* If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team.
What do we offer in return?
A career that you define.
Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more.
What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community.
Our culture: people first
Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world.
The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key.
Diversity and inclusion
At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances.
What do we offer in return?
A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us:
* Our successes have all come from someone brave enough to try something new
* We support each other in the small everyday moments and the bigger challenges
* We are determined to make a positive difference at work and beyond
Reasonable adjustments
We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*.
If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require.
* Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more.
Permanent
Auto-ApplyProfessional Liability Claim Manager
Claim processor job in New York, NY
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.
Claims Specialist
Claim processor job in Newark, NJ
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
Associate Claims Examiner
Claim processor job in Jersey City, NJ
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℠.
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, Linguistics, 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 evaluate complex issues.
Proactive; able to organize and prioritize to meet multiple demands and commitments.
Demonstrates a strong work ethic, collaborative mindset, and potential for leadership.
Location & Work Arrangement
The Early Careers Program (ECP) begins July 2026. A new hire for this role would start between January - June 2026.
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 Morristown, NJ, Jersey City, NJ, New York City, NY, or Philadelphia, PA.
Relocation and housing assistance is not provided for this role.
#LI-AM2
#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.
$60,000 - $65,000/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.
Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
14400 Arch Insurance Group Inc.
Auto-ApplyClaims Specialist
Claim processor job in New York, NY
Why Shiftsmart
We're building the Amazon of labor. We're a labor platform pairing end-to-end workforce management technology with a rapidly growing global network of 5M flexible workers to create scalable labor solutions for the largest companies and government agencies in the world like Circle K, Pepsi, Walmart, Starbucks and more. Our unique business model fractionalizes jobs down to shifts and makes it easy for workers to work across multiple companies through a digital marketplace. We're one of the fastest-growing startups in the country. We've grown 2-3x each year since we started, paid over $130M in wages to hourly workers, and raised $120M+ from top-tier investors including D1 Capital & Imaginary Ventures…
and we're only getting started.
Mission:
The mission of the Privacy and Compliance function is to ensure Shiftsmart processes and policies adhere to relevant legal and regulatory requirements and ensure positive & safe experiences for both users, clients, and company. You will be directly contributing in helping create and maintain a resource for both customers and users to assist with any privacy or legal related requests.
This role is based in New York City (HQ) with typically 4+ days in office
Outcomes:
This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.This position will evolve over time but some of your early responsibilities will include:
Gather, organize, and analyze information related to incidents and escalated complaints.
Support the creation of comprehensive written investigative reports based on gathered data.
Perform initial analysis of all escalated incidents and complaints, considering factors such as location, type of task, and the nature of the issue.
Coordinate closely with the Customer, Support, and Operations teams to compile relevant data, records, and other evidence necessary for investigative reports.
Maintain a robust tracking system to monitor the outcomes of all escalations and investigated cases.
Meet response time SLAs for communicating with partners, law enforcement contacts, and customer contacts.
Competencies:
Experience: You have 1-2 years of experience in employee relations, as a claims analyst, or in an investigatory role with the potential, motivation and ambition to grow and thrive in a fast-paced environment.
Communication: You have excellent communication skills and enjoy helping people feel heard, know how to ask the important questions, and analyze the relevant information into a report
Results driven: Takes pride in & has a track record of hitting or exceeding targets; persists in accomplishing objectives despite obstacles or setbacks. You thrive in an environment where success is measured in metrics and improvement
Collaboration: Ability to work closely with all areas of the company to be a problem solver. This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.
Highly organized: You plan, organize and execute in a highly structured way & relish bringing formality to ambiguity, ruthlessly prioritize, and feel organization is second nature to you.
Independent: Able to function with a high-level of autonomy once given a playbook.
Compensation philosophy
To provide greater transparency we share base salary ranges, which are based on role and level benchmarked against similar stage, high growth companies. Offers are determined based on multiple factors including skills, work experience, and relevant credentials.
In addition to competitive salaries and meaningful equity we offer the following benefits:
Comprehensive healthcare coverage: We cover 100% of employee premiums for medical, dental, and vision care (60-75% for dependents)
401(k) match program: We match 100% on the first 3% of your contributions and 50% on the next 2% for a maximum match of 4%
Generous, fully paid parental and family leave policies
Pre-tax commuter benefits
Collaborative office with fully stocked kitchen @ 1 World Trade in Manhattan
Equal opportunity employer
Shiftsmart is committed to creating a diverse environment and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Operating Principles @ Shiftsmart
Inspired by Leadership Principles @ Amazon
Execution Is Binary
We #GetShiftDone. We take immense pride in both the quality of our work and our relentless determination to deliver on our commitments. If we say we are going to do something, we do it.
We own the outcome with an unstoppable mindset through the finish line and are impatient to move the ball forward. This means we work really hard, execute with urgency, and ruthlessly challenge timelines for anything important. As a result, we do not defer responsibility to other teams or individuals. Instead, we take the problem as far as we can and only when needed ask others for help.
Each time a crisis or opportunity emerges we take the hill as one team, because we are allergic to the words
“it can't be done”
.
Missionaries, Not Mercenaries
We before me. We believe in our mission to build a better world for workers. We understand why our work matters and take seriously how it impacts our customers and our partners. This belief permeates everything we do from the strategic to the mundane.
We are energetic, ambitious, and want to win. We constantly raise the standards for ourselves and everyone around us. We show up for our customers, our partners, and most importantly our teammates, and make every effort to build lasting relationships with each of them.
We do not measure success based on our titles or the size of our empires. This also means we put the needs of the business before the details of our job descriptions. Rather than fight for a bigger piece of the pie, we fight to grow the entire thing and recognize this is how to grow our careers too.
Inputs > Outcomes
We work really hard. Fundamentally changing how labor works is not easy. It often requires long days, late nights, and weekends to deliver on our commitments. We lean into this challenge.
We focus on the process. We think in terms of value chains and appreciate that a bad process with a good outcome is simply dumb luck.
We lead with data. We use facts, not fiction, to build narratives and make decisions. To do this we prepare written memos in advance and resist the urge to engage in endless water cooler what ifs, because we value the time and attention of our teammates.
We hire and develop the best. When we decide to hire a new team member, we do so because we believe they will increase the talent density on our team. We view ourselves as leverage maximizers rather than inconvenience reducers and strive to increase the output of everyone we interact with.
Honesty Over Harmony
We share the truth even when it is painful. We do not, however, share the truth callously to hurt people's feelings or make them look bad. We also assume positive intent. If someone is not delivering in a way that we need, we ask them and tell them before assuming the worst.
We embrace mutual feedback. As people leaders we care more about our team's growth and success than how much others like us. As individuals we seek, accept, and apply feedback. We do not give or take feedback personally because we understand it enables us to learn and grow.
We tell the truth to ourselves. We reject a pollyannaish view of our world. Instead if something isn't going well that we are responsible for, we call it out. And when someone calls out their own truth that may be less optimal, we don't punish them for it.
We have the meeting in the meeting. If something is broken or we disagree, we call it out and say something in the moment even if it feels uncomfortable to do so. This means that if something is broken, we do not just accept it and complain later.
Invent & Iterate
We are ********************* categorically reject the phrase
“that is how it's always been done”
, and constantly discover new and better ways to do more with less. This means we are resourceful and often do things that don't scale, only to create ways to scale them later. We're builders.
We think BIG. At every level of the company, we embrace big, hairy, audacious, and transformative goals. We fear lack of progress and incremental thinking more than failing to deliver or falling short of an audacious goal. We believe courage means to try without fear and learn without ego.
We do not let perfect get in the way of better. When faced with the choice we prioritize delivering something, even if imperfect, over endless debate and alignment. We embrace good mistakes.
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