Post job

Claim processor jobs in Richland, PA - 314 jobs

All
Claim Processor
Claim Specialist
Claims Supervisor
Claim Auditor
Claims Representative
Medical Claims Processor
Claims Coordinator
Liability Claims Representative
Medical Claims Analyst
  • Cargo Claims Specialist

    Cosco Shipping Lines (North America) Inc. 3.8company rating

    Claim processor job in Secaucus, NJ

    COSCO SHIPPING Lines (North America) is seeking a proactive, detail-oriented Cargo Claims Specialist to manage cargo damage/loss claims for international container transport services. This role ensures proper investigation, documentation review, liability determination, and recovery coordination with insurers, P&I Clubs, and third parties. The position also supports reporting, audits, and prevention measures to reduce recurring claim incidents and improve operational effectiveness. Key Responsibilities: Handle cargo damage, loss, and shortage claims for COSCO SHIPPING's ocean services. Review and verify claim documentation, confirm liability, and ensure timely processing in accordance with company policies and maritime conventions. Negotiate and recommend fair settlements; coordinate with insurers, P&I Clubs, external counsel and internal departments on complex recovery cases. Pursue recovery from responsible third parties and ensure all settlements and payments are accurately recorded. Liaise with the Legal & Risk Control Department regarding litigation, arbitration, and related regulatory matters. Maintain professional communication with customers, agents, and internal teams; provide clear claim explanations. Prepare claim statistics and trend analysis; propose preventive actions to reduce reoccurring incidents. Support internal audits, claims reporting, and system updates as required. Qualifications: Bachelor's Degree 1-3 years of experience preferred Additional Requirements: Knowledge of containerized shipping operations and maritime liability regimes. Strong analytical, negotiation, and documentation skills. Proficient in MS Office and claims management systems. Excellent written and verbal communication skills; Mandarin preferred. Ability to manage multiple cases simultaneously. Prior experience in a global shipping line or P&I Club preferred. What We Offer: Comprehensive health coverage - medical, dental, and vision Flexible Spending Accounts (FSA) - for healthcare and dependent care expenses Commuter benefits - support for mass transit and parking 401(k) retirement plan - with a 100% company match up to 6% Generous Paid Time Off (PTO) Annual Discretionary Bonus - based on individual and company performance Company-paid life insurance - with optional additional coverage Fully covered short-term and long-term disability insurance Employee Assistance Program (EAP) - confidential personal and work-life support Job Type: Full-time Benefits: 401(k) 401(k) 6% Match Health insurance Life insurance Paid time off Vision insurance
    $52k-93k yearly est. 5d ago
  • Job icon imageJob icon image 2

    Looking for a job?

    Let Zippia find it for you.

  • Pharmacy Claims Specialist

    Blinkrx

    Claim processor job in Pittsburgh, PA

    This is a full-time, onsite position based in Robinson Township. Responsibilities: Process pharmacy claims accurately and timely to meet client expectations Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage Maintain compliance with patient assistance program guidelines Document all information and data discovery according to operating procedures Research required information using available resources Maintain confidentiality of patient and proprietary information Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering Requirements: High school diploma or GED required, Bachelor's degree strongly preferred One year of Pharmacy Experience, having resolved third party claims Healthcare industry experience with claims background Strong verbal and written communication skills Attention to detail and a strong operational focus A passion for providing top-notch patient care Ability to work with peers in a team effort and cross-functionally Strong technical aptitude and ability to learn complex new software Location/Hours Full time position hourly, on-site role in Pittsburgh (Robinson) Availability for Monday-Friday across various 8 hours shifts : 8am- 4pm EST , 9am- 5pm EST, 1pm- 9pm EST Availability for rotating Saturday shifts 9am-5pm Scheduling flexibility, as your schedule may change over time according to business needs Benefits Medical, dental, and vision insurance plans that fit your needs 401(k) retirement plan Daily snack stipend for onsite marketplace Pre-tax transit benefits and free onsite parking
    $38k-66k yearly est. 3d ago
  • Claims Representative, Total Loss

    Plymouth Rock Assurance 4.7company rating

    Claim processor job in Parsippany-Troy Hills, NJ

    The Total Loss Unit within our Claims Organization is responsible for identifying, negotiating and settling total losses with both insureds and claimants. The Total Loss Claim Representative processes payments and is responsible for the documentation of assigned claims as well as coordinate disposition of the total loss salvage vehicle. He/she is responsible for controlling total loss expenses and salvage recoveries on all total losses assigned. Responsibilities: Negotiates and communicates all total loss and diminished value settlements per company and state guidelines. Multi jurisdictions, including MA, NH, CT, NY, and others as required Understands the total loss evaluation methodology processes with the ability to effectively communicate these to vehicle owners. Has a basic understanding of vehicle financing / leasing. Reviews damage estimates to confirm vehicles are total losses. Documents all settlements and actions in the claim file system. Works directly with salvage vendor to move vehicles and obtains salvage bids where necessary Negotiates and settles claims within his/her individual authority. Submits claims for approval to supervisor when over his/her authority or for guidance, review and/or referral when appropriate. Escalates claims to supervisor that are not moving in a positive direction. Maintains an effective diary system on pending files. Prioritize and handle multiple tasks simultaneously. Quickly adjusts to fluctuating workload and responsibilities. Keeps involved parties and agents updated on the status of the claim and emerging issues. Ensures that service, loss and expense control are maintained at all times. Adheres to privacy guidelines, law and regulations pertaining to claims handling. Prepares payments to vehicle owners, banks and lease companies. This role will report in person to our Boston office, located directly across from South Station. Qualifications: Property and casualty claims handling experience desired Ability to work independently and in a team environment Excellent oral and written communication skills Excellent organizational skills Solid problem solving skills Proficient in Word, Excel, MS Outlook Salary Range: The pay range for this position is $48,000 to $73,500 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. Perks and Benefits: 4 weeks accrued paid time off + 9 paid national holidays per year Robust wellness & health and fitness reimbursement programs 401(k) bonus program Tuition reimbursement Auto and home insurance discounts Volunteer opportunities 2:1 donation matching program Company-paid life and disability insurance plans Optional medical, dental, vision, legal, pet insurance, FSA and identity theft protection plans The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
    $48k-73.5k yearly 5d ago
  • Senior General Liability Claim Representative

    CWA Recruiting

    Claim processor job in Union, NJ

    Senior General Liability Claim Representative - Property & Casualty Insurance Industry Union County NJ The management of accounts and the processing of claims related to litigated matters in hotels, real estate, hospitality, liquor liability, general liability, and bodily injury cases is a specialized function. This role necessitates an individual with a personality geared toward customer satisfaction. Responsibilities also include the negotiation of claims that are under litigation. Candidates should have at least 3 to 5 years of experience in handling middle market claims and possess a college degree. A valid New York adjuster's license is essential, while licenses from other states are considered a plus.
    $48k-70k yearly est. 5d ago
  • Claims Coordinator

    Alpha Business Solutions

    Claim processor job in Philadelphia, PA

    We're hiring an Inter-Plan Relations Coordinator in Philadelphia for a 4+ month contract to support complex and escalated provider and member claim issues across partner health plans. Key responsibilities include: Owning partner plan inquiries end to end, ensuring timely and compliant resolution Investigating claim issues, performing root-cause analysis, and supporting reprocessing or adjustments Acting as a liaison between internal teams, providers, and partner plans Managing escalations and supporting process improvement initiatives This role is ideal for candidates with claims, BlueCard/Inter-Plan, or service operations experience.
    $31k-40k yearly est. 3d ago
  • Claims Examiner II (PIP)

    Athens Administrators 4.0company rating

    Claim processor job in Parsippany-Troy Hills, NJ

    DETAILS Claims Examiner II - PIP Department: Property & Casualty Reports To: Claims Supervisor P&C FLSA Status: Exempt in all states but CA Job Grade: 11 Career Ladder Next step in progression could include Senior Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner II to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe no-fault auto liability claims with an opportunity to handle Commercial Property, Inland Marine, and General Liability claims. These claims are typically moderate exposure and may entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Investigate, evaluate, and determine settlement value of moderate level PIP commercial auto claims Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure. Ensure appropriateness of all payments Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers Attend meetings and educational seminars for professional development Maintain required licenses Conduct quarterly claim reviews with the client ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states. Minimum of 5 years PIP claims handling experience NY PIP experience preferred Knowledge regarding the handling and resolutions of arbitrations relating to New York PIP Knowledge of laws and regulations regarding PIP in multiple jurisdictions. Primary jurisdictions would be NY, FL, and NJ Knowledge of tort law, civil procedure, and contract law Knowledge of auto insurance laws, codes, procedures, and liability concepts Knowledge of property and casualty insurance policies Negotiation skills Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here
    $51k-77k yearly est. 60d+ ago
  • Claims Specialist

    Berkley 4.3company rating

    Claim processor job in New Jersey

    Company Details Berkley Luxury Group is an operating unit of W.R. Berkley Corporation, one of America's largest commercial lines writers in the United states. At Berkley Luxury Group we offer tailored, all-inclusive insurance solutions for luxury condo, co-op, rental properties and fine dining restaurants. Berkley Luxury Group has been a mainstay in the commercial real estate and hospitality business since 1986. We specialize in luxury condominiums, cooperatives, and apartments in the habitational space, Class A Office buildings and fine dining restaurants in the hospitality space. BLG maintains a standard of prompt and fair settlement of claims, and endeavors to treat insureds and brokers in a partnership-like manner. BLG has developed a strategic plan to grow their success by expanding their footprint geographically and adding complementary products. At BLG there is a shared vision to be the best option for its customers. We aim to provide comprehensive insurance solutions, use enhanced data and technology to make more informed decisions and rely on a field-based underwriting, claims and loss control model to be closer to our customers and brokers. Our goal is to provide superior services and products to these unique businesses. At Berkley Luxury Group, our employees are our most important asset. We recognize that if we properly support and develop our employees, they will become our primary sustainable competitive advantage and the key to achieving success. As such, we have created a high performing culture incorporating our values into work practices, policies, and processes to foster, reinforce and sustain an environment where employees share a strong sense of purpose, commitment, and motivation to meet and exceed their goals. As a Berkley company, we enjoy operational flexibility that allows us to deliver quality coverage solutions. W. R. Berkley Corporation, and all member insurance companies, are rated A+ (Superior) by A.M. Best Company and carry Standard & Poor's Financial Rating of A+ (Strong). The company is an equal opportunity employer. Responsibilities Berkley Luxury is seeking a Senior Claims Specialist to join our team! This role is located is our new Parsippany NJ office. As a Claim Specialist, you will manage a wide range of commercial lines casualty claims, focusing on developing and implementing effective resolution strategies while delivering exceptional customer service. In this role, you will ensure high-quality claims handling through investigation, accurate analysis of coverage and liability, precise damage assessment, and resolution of claims, including those in litigation. As a key member of the casualty team, you will also help foster a culture of accountability, collaboration, continuous learning, and proactive performance improvement-contributing to both departmental excellence and the overall success of the company. Conduct thorough investigation and expert analysis of claims facts to determine coverage, liability, and applies appropriate legal concepts to evaluate damages and recommend appropriate course of action. Analyze and interpret policy language and case law in conjunction with specific loss facts to reach appropriate coverage decisions and write appropriate coverage correspondence in compliance with state statutes and regulations. Demonstrate a strong sense of urgency in promptly conducting comprehensive claims investigations to assess damages and liability, establish accurate reserves, and actively pursue timely and appropriate resolutions. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposures, risk transfer, reserve adjustments, coverage issues, and claim resolution strategies. Resolve claims through negotiation, mediation, and arbitration with minimal assistance. Address inquiries from brokers and policyholders and provide superior customer service. Attend and participate in industry related conferences, seminars, and webinars and demonstrating a personal commitment to professional development. Ensure claims handling compliance and alignment with insurance regulations and Company policies. May participate in projects and other corporate initiatives such as audits, task forces, focus groups, etc. Other duties as required. Qualifications Education Bachelor's degree or equivalent experience JD degree a plus Experience 5-7 years of experience handling commercial general liability claims. Experience managing litigated claims and working with defense counsel. Proven track record of effective claims resolution and negotiation. Technical Skills Strong knowledge of claims investigation techniques, liability assessment, and damage evaluation. Demonstrated expertise in legal processes and litigation management. Ability to interpret and apply policy language accurately. Analytical & Decision-Making Demonstrated critical thinking and sound judgment in analyzing claims. Advanced analytical abilities to evaluate liability, quantify damages, and determine exposure. Proven capacity to make prompt, well-reasoned, and evidence-based decisions. Communication & Interpersonal Excellent written, verbal, and presentation communication skills. Effective communicator with diverse stakeholders, including policyholders, claimants, attorneys, and internal teams. Strong negotiation skills Organizational & Time Management Strong organizational skills with attention to detail. Effectively manages priorities and meets deadlines in a fast- paced environment. Team & Culture Fit Takes ownership, shows initiative, and approaches problem-solving with a proactive mindset. Collaborative team player dedicated to achieving shared goals. Committed to continuous improvement and ongoing professional development. Supports and upholds the company's commitment to equal employment opportunity. Additional Company Details The company is an equal opportunity employer. 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: $83,000 - $156,000 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 Not ready to apply? Connect with us for general consideration.
    $83k-156k yearly Auto-Apply 31d ago
  • Executive Claims Specialist - Gig Economy

    Cfins

    Claim processor job in Morristown, NJ

    Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: ************** Job Description S&S Transportation & Sharing Economy is seeking an experienced Executive Claims Specialist to join our dynamic team. In this role, you will provide expert oversight of Bodily Injury (BI); Property Damage (PD) and Personal Injury Protection (PIP) claims managed by Third-Party Administrators (TPAs), specifically arising from rideshare-related incidents. The ideal candidate will possess substantial expertise in complex injury claims, with a strong background in the rideshare sector. What you will do for C&F: TPA Oversight: Provide technical supervision and guidance for BI and PIP claims handled by TPAs, ensuring adherence to program standards and best practices. Claims Management: Apply advanced knowledge to oversee rideshare claims, including coverage analysis and litigation management. Technical Excellence: Drive optimal claim outcomes by controlling indemnity, expense, and litigation costs through timely reserving, trial preparation, and resolution strategies. Auditing: Conduct regular audits of TPA-managed claims to ensure accuracy, timeliness, and compliance with established procedures. Data Analysis: Review claims data, reserve adequacy, and performance metrics to identify trends and recommend process improvements. Industry Awareness: Stay informed on evolving rideshare regulations, policy changes, and litigation developments. Additional Duties: Perform other related tasks as assigned. What you will bring to C&F: Experience: Minimum 6-8 years handling complex bodily injury and litigated claims, with direct experience in rideshare claims required. Expertise: In-depth knowledge of BI and PIP claim procedures; experience with high-value BI, PIP, and Property Damage exposures related to rideshare incidents. Education: Bachelor's degree required; law degree, professional designations, or insurance coursework a plus. Licensing: Ability to obtain and maintain required state licenses. Communication: Excellent verbal and written communication skills, with the ability to interact effectively at all organizational levels. Technical Skills: Proficiency in Microsoft Office suite. Travel: Occasional travel may be required. Risk Transfer: Understanding of claims policy language and coverage necessary to evaluate Risk Transfer with PAP carriers. What C&F will bring to you Competitive compensation package Generous 401K employer match Employee Stock Purchase plan with employer matching Generous Paid Time Off Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path A dynamic, ambitious, fun and exciting work environment We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community At C&F you will BELONG If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information. Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $64,700.00 to a maximum of $121,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs. #LI-AV1 #LI-Remote
    $64.7k-121.6k yearly Auto-Apply 23h ago
  • Associate Claims Examiner

    Markel Corporation 4.8company rating

    Claim processor job in Summit, NJ

    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. Associate Claims Examiner will be responsible for the resolution of claims with the Prompt Resolution Team (PRT) of lower complexity and exposure. This position will have decision-making authority in the amount of $25,000 and work under the general direction of their manager. The ACE position supports all product lines in Casualty with particular emphasis on Binding and Commercial Wholesale Primary and Small Commercial Programs. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims. * 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. * Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. * Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications * Must have or be eligible to receive claims adjuster license. * Successful completion of basic insurance courses or achievement of industry designations. * Ability to be trained in insurance adjusting up to two years of claims experience. * 2-4 years of experience in general liability, construction defect, or related liability lines preferred. * Bachelor's degree preferred * Excellent written and oral communication skills. * Strong organizational and time management skills. #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 salary for the position is $25 - $38.25 with a 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.
    $49k-72k yearly est. Auto-Apply 60d+ ago
  • Damage Claims Specialist

    HTSS

    Claim processor job in Allentown, PA

    Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries. Job Qualifications: Bachelor's Degree (preferred); High School Diploma or equivalent (required) Minimum of three (3) years experience in claims handling Proficiency in Microsoft Office Suite, especially Word and Excel Strong verbal and written communication skills Excellent problem-solving and conflict-resolution abilities High attention to detail and ability to work independently Pay: Based on experience This is a full-time, temporary role expected to last at least 6 months. If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
    $40k-71k yearly est. Easy Apply 60d+ ago
  • Damage Claims Specialist

    HTSS, Inc.

    Claim processor job in Allentown, PA

    Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries. Job Qualifications: Bachelor's Degree (preferred); High School Diploma or equivalent (required) Minimum of three (3) years experience in claims handling Proficiency in Microsoft Office Suite, especially Word and Excel Strong verbal and written communication skills Excellent problem-solving and conflict-resolution abilities High attention to detail and ability to work independently Pay: Based on experience This is a full-time, temporary role expected to last at least 6 months. If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
    $40k-71k yearly est. Easy Apply 4d ago
  • Indemnity Claims Specialist

    Insight Global

    Claim processor job in Norristown, PA

    Insight Global is looking for a Senior Indemnity Adjuster to join our client's team. Responsibilities will include managing complex workers' compensation claims, ensuring fair and efficient resolution while maintaining compliance with state regulations. The ideal candidate will have extensive experience handling indemnity claims, negotiating settlements, and collaborating with medical and legal professionals. This candidate will handle a desk with at least 50-70% litigation and would only have a small amount of med only files. Claims total would be around 135. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements Indemnity Claims Experience; specifically litigation claims Minimum 3 years of Complex Claims Experience Experience with NJ, PA and DE Claims
    $40k-72k yearly est. 13d ago
  • Auto Claims Specialist I (Manheim)

    Cox Enterprises 4.4company rating

    Claim processor job in Manheim, PA

    Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description This position facilitates the resolution of customer claims and concerns (includes all physical and digital/online transactions) after a sale and is responsible for the timely and successful arbitration of vehicles between buyer and seller in accordance with auction and NAAA policies. The role will work to gain familiarity with fundamental arbitration concepts, procedures, standards, policies and systems. This position requires organization and management of sale day activities including post sale inspections and sale day arbitrations. Job Responsibilities: Basic Functional Duties * With guidance, performs basic Arbitrator duties, including: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluates claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communications for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. Knowledge & Subject Matter Milestones * Demonstrates an understanding of investigating claims and negotiating and influencing others while maintaining a positive client experience. * Gains familiarity and understanding of Arbitration concepts and procedures. * Gains foundational understanding of auction-specific operational and administrative processes. * Learns and adheres to National Auto Auction Association (NAAA) arbitration standards, Manheim Marketplace Policies, and relevant legal requirements. Client Interaction/Communication Responsibilities * Advises clients of the arbitration claim process, company policies, any auction- or account-specific guidelines, and NAAA guidelines. * Facilitates both written and verbal communications between buyers, sellers, and various auction team members and third parties to actively gather information necessary to guide parties toward agreement and resolution, while maintaining an awareness of goals and objectives. * Provides relevant information such as claim status to clients. Other Duties * Demonstrates safety commitment by following all safety and health procedures and modeling the appropriate behaviors. * Participates in support of all safety activities aligned with Safety Excellence. * Performs other duties as assigned. Qualifications and Experience * Education * High School Diploma or equivalent required. * Bachelor's degree preferred. * Experience * Previous experience in claims management and/or problem and conflict resolution preferred. Claim adjuster experience is a plus. * 1-2 years of experience in areas of responsibility. * 1+ years of automotive, mechanical, and/or body shop experience preferred. * Skills and Abilities * Active Listening * Accuracy and Attention to Detail * Resilience/Adaptability * Demonstrates Empathy * Verbal and Written Communication * Decision Making * Customer Focus * Time Management * Conflict Resolution * Builds Positive Relationships YDGCOX Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
    $16.6-24.9 hourly Auto-Apply 6d ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim processor job in Harrisburg, PA

    Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
    $82.8k-97.3k yearly Auto-Apply 60d+ ago
  • Claims Specialist 3- Staffing

    Circet USA

    Claim processor job in Englewood Cliffs, NJ

    Job Description Circet USA is the leading provider of Network Services in North America, and we're looking for talented professionals to join our team. We specialize in engineering and construction services delivering comprehensive solutions across Inside Plant, Outside Plant, and Wireless networks to meet the evolving infrastructure needs of our customers. With nearly 50 years of industry experience, we work with major telecom service providers, MSOs, cloud service providers, and utilities. At Circet USA, you'll have the opportunity to make an impact by helping to create customized solutions that address our clients' unique challenges. If you're passionate about innovation and thrive in a dynamic environment, we'd love to hear from you. Circet USA's benefits package includes the following: Medical, Dental, and Vision insurance Digital Health & Wellness Support Critical Illness, Accident, & Hospital Insurance Short-term & Long-term disability Group term & Voluntary life insurance Flexible Spending and Health Savings Accounts Paid Time Off & 401K Company Discount Website Responsibilities We are seeking a highly skilled and experienced Claims Specialist 3 to fulfill a staff augmentation role with Circet USA's customer. The primary objective of the Claims Specialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management. The goal of the Claims Specialist is to support the Product Safety Team by handling Claims with professionalism, care and urgency, making sure claims are reported and being handled in a timely manner. To achieve the highest performance, the person in this position is expected to maintain effective and timely communication with key customers, claims adjusters, stakeholders and leaders within the department, team, and cross-department where applicable. ESSENTIAL DUTIES & RESPONSIBILITIES include the following. Other duties may be assigned: Collaborate with team members in the Product Safety department, PL Insurance Carrier, outside law firm and 3rd Party administrators. Generate daily/weekly/monthly reports, with analysis and recommendations Manage 4-7 ongoing and ad-hoc projects that may include KPIs and Metrics Ensure that all projects have required documentation as they move through the project tollgates Communicate to Product Liability leadership on project status and escalation/decision points Works cross functionally with HQ teams in Korea (occasional evening conference call) and SEA operations to manage all possible risks. Pending Claim Management, KPI & TAT Management - Claim registration to closure Product Verification Liability Assessment by reviewing diagnosis results Reporting on high-profile claims to the leadership Qualifications Bachelor's Degree (or equivalent experience) 3-5 years of hands-on claims management & customer care experience Expertise in MS, Excel, and PPT Proven capability to analyze data and develop a course of action Proven ability to prioritize and manage multiple projects, meet deadlines and drive to resolution Process, procedure, strategic planning and project development experience Experience working with and influencing cross-functional teams. Experience working within the insurance and/or home appliance industry a plus Experience with product development or testing a plus Experience working in a complex and wide organization and department Claims Adjuster License a plus Takes project ownership and possess leadership qualities with an entrepreneurial approach Circet USA is an Equal Opportunity Employer - Veteran/Disabled. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by law.
    $44k-79k yearly est. 16d ago
  • Ambulatory Care Capacity Analyst - Jefferson Medical Group - Center City

    Kennedy Medical Group, Practice, PC

    Claim processor job in Philadelphia, PA

    Job Details The Ambulatory Care Capacity Analyst provides strategic support for provider access initiatives across the Jefferson Medical Group (JMG). This role provides internal schedulers and patients a standard, comprehensive approach to appointment availability across the enterprise. Job Description Essential Functions: Responsible for building, maintaining, and modifying centralized scheduling templates for all scheduling providers, including resource providers · Ensure all approved template changes follow change management procedures and protocols and align with Jefferson's template strategy guidelines Provide impact analysis for master template changes Report, review, and reschedule patient appointments as indicated by the Reschedule List Collaborate with Ambulatory practice administrative and clinical leadership on template optimization through the use of Epic Cadence functionality and advise on best practices Participate in department meetings that address patient access-related metrics Identify potential access limiting factors and develop possible solutions for department collaboration Monitor the effectiveness of access-related initiatives using data analysis via Qlik Reporting, Epic Reporting Workbench, and excel Strategize operational and technical methodologies to enhance patient self-scheduling for both patients and the ambulatory practices Present, demonstrate, and train internal staff on access and capacity strategies and initiatives On-board providers on scheduling decision tree and open scheduling platforms Rotate with peers for on-call schedule Education and Experience: High School Diploma Required; Bachelor's Degree preferred. Epic Cadence or other Epic application certification - plus. Minimum 2-3 years experience in an ambulatory care or IT setting preferred. Prior scheduling template management experience preferred. Work Shift Workday Day (United States of America) Worker Sub Type Regular Employee Entity Jefferson University Physicians Primary Location Address 1101 Market, Philadelphia, Pennsylvania, United States of America Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educa tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. Benefits Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance. For more benefits information, please click here
    $33k-52k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist

    Connectiverx 3.7company rating

    Claim processor job in New Jersey

    Being on medication is tough enough. We want to make getting it the easy part. Getting prescriptions to patients has become increasingly complex. When things get messy along the prescription journey, pharmaceutical manufacturers rely on us to untangle the process and create a clear path-allowing patients to build trusting relationships with their medication brands. We're not only committed to taking the pain out of the prescription process, but we're also devoted to bringing the brightest minds together under one roof. We bring together diverse voices-engineers, pharmacists, customer service veterans, developers, program strategists and more-all with one vision. Each perspective and experience makes ConnectiveRx better than the sum of its parts. The Claims Specialist, under the direction of the Supervisor (with guidance from a Team Lead), is responsible for processing medical claims received from patients and/or HCPs across a broad product suite. An individual in this role is expected to meet or exceed productivity and quality standards. Associates possess a solid understanding of department processes, products, and operational tools/systems. This position utilizes ConnectiveRx and 3rd party systems to process claims and respond to inquiries from patients, physicians, pharmacies, and clients. The Associate may be assigned additional responsibilities by the Supervisor. Responsibilities Verifies the accuracy and completeness of claim forms and attachments, such as EOBs, EOPs, SPPs, and pharmacy receipts. Information is entered into adjudication systems as required. Claims are paid or rejected based upon system adjudication and/or application of business rules external to the systems. Consult with the Team Lead or Supervisor for complex claims or clarification of business rules. Obtains missing information by calling or writing customers using standard scripts or form letters. Based on volume, may also process claims and/or answer phones Refers to requests for escalation as needed and engages other internal areas such as Program Management, IT, and other Contact Center teams to resolve issues. Provide input and feedback to the Supervisor, Quality Management, and Training (among others) to improve processes, procedures, and training. Other projects and tasks as assigned Qualifications High School or GED required 1+ years in a health care or case management setting Experience working in pharmacy benefits, health care insurance, and/or medical billing a must Health care or pharmaceutical experience, particularly in a medical claims processing, billing provider, or insurance environment Knowledge of EOB and EOP statements Prior experience in a high-volume processing setting (i.e., doctor's office, claims processing department, etc.) a plus. Will be trained to support programs, clients, and/or job functions as appropriate Experience with Third-Party systems (SelectRx, Pro-Care, FSV) (preferred) Fluent in English/Spanish (a plus). Knowledge of Medical Claims processing/billing coding Communication skills: Uses writing effectively to create documents, uses correct spelling, grammar, and punctuation; Ability to convey written and verbal information in easy-to-understand language. Customer Focus: High level of empathy and emotional intelligence; Focuses on the opportunity to service patients with a high level of empathy Detail Oriented: Achieves thoroughness and accuracy when accomplishing a task Adaptability: Adapts to a variety of situations easily and effectively navigates situations Problem Solve; Thinks critically, and problem-solves issues to resolution Compensation & Benefits: Compensation for this role varies based on factors such as location, relevant skills, experience, and capabilities. Employees at ConnectiveRx can enroll in comprehensive benefit plans, including medical, dental, vision, life, and disability insurance. The company retains the right to update or modify health, welfare, and other fringe benefit policies. Employees may also participate in the company's 401(k) plan. Time-Off & Holidays: ConnectiveRx provides paid time off (PTO) to non-exempt employees for vacations and personal leave. For sick leave, eligible non-exempt employees receive Sick Time Off (STO) in accordance with company policy. PTO and STO are prorated during the first year of service. Employees also receive eight standard company holidays and three floating holidays annually, with floating holidays prorated in the first year. The company is committed to maintaining competitive benefits and reserves the right to adjust employee offerings, including PTO, STO, and holiday policies, in compliance with applicable laws and regulations. Posted Salary Range USD $17.51 - USD $22.95 /Hr.
    $17.5-23 hourly Auto-Apply 30d ago
  • Third Party Claims Specialist

    DCS Asset Maintenance 4.5company rating

    Claim processor job in Hazleton, PA

    DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family! To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about! Job Description Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA. Duties include - but not limited to: Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies. Coordinate with project offices to obtain accurate information, records and photos needed to create invoices. Creation and submission of accurate invoices to insurance carriers and vehicle owners. Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days. Accurately updating claim records for any contact or actions taken on claim invoice. Create and run reports as necessary for claim tracking and follow-up Support to project offices as necessary - including police report investigation and contacting insurance companies. Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage. Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager. Other duties as assigned. Qualifications EDUCATION: High School Diploma is required. EXPERIENCE: Prior experience in insurance claims preferred - 2 years or more relative experience Excellent computer skills - Proficient in Microsoft Office Word & Excel Customer service focused Detail oriented Self-starter - ability to work independently. Ability to interact productively and positively in a team environment. Ability to communicate effectively and professionally in both verbal and written form. PHYSICAL REQUIREMENTS: Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone. Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices. Able to see and read on computer screens and paper, close vision. Ability to lift and carry items up to 10 pounds. Ability to sit at a desk comfortably while working on a computer for extended periods of time. Additional Information Benefit Highlights: Challenging and rewarding work environment Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) Generous Paid Time Off Career Development Pay rate: $20.00-23.00/hour depending on experience Come be a part of the DeAngelo family, today! DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
    $20-23 hourly 2d ago
  • Litigation Claims Specialist

    Questor Consultants, Inc.

    Claim processor job in Deptford, NJ

    Job DescriptionRisk Intermediary located in New Jersey seeks a VP of Claims for a Municipal Insurance fund. Claims handled are Workers Comp, Property and Liability and Professional Liability. Fund has 28 members submitting New Jersey based Public Entity based claims. This position will lead operational and administrative claims functions including reserving. Will also manage TPA relationships and direct TPA's Workers Comp activities. Will also manage staff Liability Litigation Managers and lead claims reporting. Require JD with 20 years experience in an Insurance Claims Department, TPA or Risk Management Department. Knowledge of New Jersey Civil Tort and Workers Comp claims systems. Advanced skills in Coverage Analysis, Litigation Management and Negotiation. Auto Liability, General Liability and Employer Liability claims. Knowledge needed in MS Office Products (Word, Excel and Powerpoint). Will work remote but must be within driving distance of office. Will manage 9-12 people. Minimal travel. Salary $150-200k no bonus opportunity.
    $45k-80k yearly est. 18d ago
  • Claims Specialist

    Sales Match

    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
    $22-27 hourly 60d+ ago

Learn more about claim processor jobs

How much does a claim processor earn in Richland, PA?

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

Average claim processor salary in Richland, PA

$39,000
Job type you want
Full Time
Part Time
Internship
Temporary