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Claim processor jobs in Rockville, MD - 159 jobs

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  • Claims Representative II

    Davies Talent Solutions

    Claim processor job in Baltimore, MD

    Davies Claims North America seeks an experienced Claims Representative to manage claims related to MTA operations, including minor property damage and complex bodily injury. Reporting to the MTA Claims Supervisor, this role involves investigation, litigation management, and reserve evaluation for claims exceeding $25,000. Key Responsibilities: Handle a caseload of 150+ files, some with multiple claimants Investigate claims, manage litigation, and maintain detailed documentation Evaluate reserves and issue timely reports Uphold company values: Dynamic, Innovative, Connected, Collaborative Perform additional duties as assigned Requirements: High school diploma or equivalent Minimum 3 years of experience in auto property damage, bodily injury, and general liability claims Proficiency in Microsoft Office Familiarity with Medicare reporting requirements (Section 111) Benefits: Medical, dental, and vision coverage 401(k) with employer match Paid holidays and time off Life, short-term, and long-term disability insurance
    $37k-57k yearly est. 4d ago
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  • Claims Examiner

    Harris 4.4company rating

    Claim processor job in Washington, DC

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $44k-62k yearly est. Auto-Apply 42d ago
  • Claims Processor - Entry Level (BS Degree Required)

    Millenniumsoft 3.8company rating

    Claim processor job in Baltimore, MD

    Claims Processor - Entry Level Duration : 5 Months Total Hours/week : 40.00 1 st Shift Client: Medical Device Company Job Category: Customer Service Level of Experience: Entry Level Employment Type: Contract on W2 (Need US Citizens or GC Holders Only) Work days/hours: M - F 8am - 5pm Job Description: The primary responsibility of this position is the investigation, analysis, resolution, trending and corrective action of all claims/complaints. Specific responsibilities include maintaining claim/complaint files and supporting the resolution of claim/complaint CAPAs to closure and verification of CAPA effectiveness. Bachelor's degree required. Minimum of 2 years of experience in complaint investigation. Strong communications and problem solving skills. Ability to work independently. Competent using office software including Database management, MS Word, Excel, Internet Explorer, PowerPoint, and Outlook. Experience with SAP is required.
    $39k-64k yearly est. 60d+ ago
  • Claims Innovation - Senior Analyst - Casualty or Commercial PD

    Geico 4.1company rating

    Claim processor job in Chevy Chase, MD

    At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. About GEICO The Government Employees Insurance Company (GEICO) is a private American auto insurance company with headquarters in Chevy Chase, Maryland. GEICO is a wholly owned subsidiary of Berkshire Hathaway and is the third largest auto insurer in the United States. In 2023, GEICO earned premiums worth over $40 billion U.S. dollars. GEICO is going through a massive digital transformation to re-platform the Insurance industry, removing friction across Customers, Partners, Marketplace, Segments, Channels, and Experiences as we grow our reach and market share. About The Role GEICO is hiring a Innovation Analyst to join their Claims Innovation team. As an Innovation Analyst, you will support GEICO's Claims Innovation team in identifying, analyzing, and implementing opportunities to improve processes and technology. This role partners with cross-functional teams to deliver innovative solutions that enhance efficiency, accuracy, and customer experience. Responsibilities: Evaluate and analyze existing claims processes, data, and performance metrics to identify areas of opportunity for efficiency, effectiveness, or accuracy Gather and analyze data to provide insights into claims processes and performance metrics Support the development of actionable strategies and assist in implementing process and technology enhancements. Assist the Director, Claims Innovation in establishing priorities, goals, and objectives Collaborate with Operations, Product, AI/ML, and Engineering teams to define and prioritize requirements. Prepare reports and presentations summarizing findings, recommendations, and project progress. Contribute to and/or lead pilot programs, POC's, or A/B testing and reporting on performance and progress Participate in innovation workshops, ideation sessions, and design sprints. Monitor project risks, benefits, and performance metrics; escalate issues as needed. Stay informed on industry trends, emerging technologies, and best practices. About You Skills & experiences: 3+ years of experience in business process optimization, business analysis, consulting, innovation, or process engineering. Leadership experience in P&C insurance claims Bachelor's degree in Business, Finance, Economics, Statistics, or related field. Knowledge of innovation methodologies, processes, and principles Strong analytical skills and ability to interpret data for decision-making. Effective communicator with strong collaboration skills. Demonstrated ability to adapt and learn in a fast-paced environment. Commitment to diversity, equity, and inclusion. Leadership qualities: Leads from the front and isn't shy about using their voice Ability to lead and influence with empathy and humility Ability to navigate and lead through complexity Curiosity, critical thinking skills; a lifelong learner who sees situations through multiple lenses Exceptional character and an ability to instill confidence and build trust. Someone who possesses high emotional intelligence, and is an attentive, empathetic listener Location: Remote, or available office #LI-HB1 Annual Salary $82,000.00 - $172,200.00 The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations. At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
    $82k-172.2k yearly Auto-Apply 16d ago
  • Outside Property - Experienced Claim Representative

    Travelers Insurance Company 4.4company rating

    Claim processor job in Rockville, MD

    **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $67,000.00 - $110,600.00 **Target Openings** 1 **What Is the Opportunity?** LOCATION REQUIREMENT: This field position services Insureds/Agents in the Maryland area. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. *You will be issued a company vehicle for this position.* Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. **What Will You Do?** + Handles 1st party property claims of moderate severity and complexity as assigned. + Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. + Broad scale use of innovative technologies. + Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. + Establishes timely and accurate claim and expense reserves. + Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. + Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. + Writes denial letters, Reservation of Rights and other complex correspondence. + Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. + Meets all quality standards and expectations in accordance with the Knowledge Guides. + Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. + Manages file inventory to ensure timely resolution of cases. + Handles files in compliance with state regulations, where applicable. + Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. + May provides mentoring and coaching to less experienced claim professionals. + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. + CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. + Must secure and maintain company credit card required. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. + This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + General knowledge of estimating system Xactimate. + Two or more years of previous outside property claim handling experience. + Interpersonal and customer service skills - Advanced. + Organizational and time management skills- Advanced. + Ability to work independently - Intermediate. + Judgment, analytical and decision making skills - Intermediate. + Negotiation skills - Intermediate. + Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate. + Investigative skills - Intermediate. + Ability to analyze and determine coverage - Intermediate. + Analyze, and evaluate damages -Intermediate. + Resolve claims within settlement authority - Intermediate. + Valid passport. **What is a Must Have?** + High School Diploma or GED. + One year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program. + Valid driver's license. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .
    $67k-110.6k yearly 23d ago
  • Claims Examiner

    Healthcare Support Staffing

    Claim processor job in Annapolis, MD

    Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Essential Functions: Reviews providers' disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures. Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness Perform any projects delegated by claims supervisor Qualifications Minimum Education/ Licensures/Qualifications High School Diploma or GED 1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting Healthcare Background Understanding of Medical Terminology Additional Information Shift: M-F 8am-5pm RTH or Temp-To-Perm (Any transition heavily depends on performance) Pay Rate: Up to 20/hour
    $37k-66k yearly est. 1d ago
  • Claims Examiner

    Harriscomputer

    Claim processor job in Washington, DC

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $29k-51k yearly est. Auto-Apply 42d ago
  • Property Claims Specialist

    Erie Insurance 4.6company rating

    Claim processor job in Silver Spring, MD

    Division or Field Office: Claims II Division Property Damage Dept Work from: Home in Maryland Salary Range: $79,191.00 - $126,500.00 * salary range is for this level and may vary based on actual level of role hired for * This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment. At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. Benefits That Go Beyond The Basics We strive to be Above all in Service to our customers-and to our employees. That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work. * Low contributions to medical and prescription premiums. We currently pay up to 97% of employees' monthly premium costs. * Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service. * 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension. * Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave. * Career development. Including a tuition reimbursement program for higher education and industry designations. Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. Position Summary Exercises independent discretion or judgment in the handling of assigned property claims. Serves as a consultant to claims adjusters in their handling of property losses. * This is a remote, work from home position * A company car will be provided * The candidate will ideally live in and service the DC, Southern MD & Eastern Shore territory Duties and Responsibilities * Establishes immediate contact with Policyholders and claimants. * Conducts extensive investigations into causes and origins of all major property claims. Interviews insureds, claimants and others as required. Inspects property damage, reviews information to prepare estimates, evaluates and makes recommendations regarding coverage of claims, determines liability and total value of claims and negotiates settlements. Sets and maintains adequate reserves. * Exercises discretion and independent judgment in evaluating property damage in order to determine the extent of damage. Determines liability and total value of claim, develops estimate and obtains an agreed scope of work and cost of repair with contractor and/or Policyholder. * Determines value as they apply to the coverage. * Determines steps necessary to initiate investigation of a property loss. Uses outside experts and attorneys as required. * Documents claim files and submits final report to file for closure. * Assigns and supervises the handling of property losses by independent adjusters when necessary. Advises claims adjusters regarding handling of claims. * Conducts related training of field office claims personnel in the branch and at the Home Office. * Attends industry-related training programs to stay current on legal developments and ensure compliance with applicable laws and regulations impacting the operation of the department. * Establishes and maintains relationships with local, state and regional organizations and agencies which are involved in related activities. * Acts as coordinator of the Catastrophe Team activities at catastrophe site. The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished. This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become clear. Capabilities * Values Diversity * Self-Development * Nimble Learning * Collaborates * Information Management Skills * Customer Focus * Cultivates Innovation * Job-Specific Knowledge * Instills Trust * Optimizes Work Processes (IC) * Ensures Accountability * Decision Quality Qualifications Minimum Educational and Experience Requirements * High School Diploma or GED and five years of claims handling experience (up to two years of equivalent may be substituted); or * Bachelor's Degree and three years of claims handling experience, (up to two years of equivalent experience may be substituted.) Additional Experience * Working knowledge of Windows software required. * The position requires the incumbent to serve on Catastrophe Team, which may include travel on short notice to other locations for periods in excess of two consecutive weeks. * Position requires the incumbent to provide 24-hour availability for emergency claims service. Designations and/or Licenses * Successful completion of Introduction to Claims (AIC 30) and AIC 35 preferred. * Appropriate license as required by state. * Valid driver's license and good driving record required. Physical Requirements * Use of Personal Protective Equipment (PPE) is required for this role. * Ability to move over 50 lbs using lifting aide equipment; Often (20-50%) * Climbing/accessing heights; Moderate (30-40%) * Driving; Frequent (50-80%) * Lifting/Moving 0-20 lbs; Often (20-50%) * Lifting/Moving 20-50 lbs; Often (20-50%) * Manual Keying/Data Entry/inputting information/computer use; Often (20-50%) * Pushing/Pulling/moving objects, equipment with wheels; Occasional (
    $79.2k-126.5k yearly 2d ago
  • Senior Claims Analyst

    Coast and Harbor Associates

    Claim processor job in Washington, DC

    Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with: Furnishes reports with supporting information necessary to resolve disputes or defend against the claims, Prepares and assembles appeal files, Participates in meetings or negotiations with claimants, Appears in legal proceedings, Prepares cost estimates for use in claims negotiations, Prepares risk assessments/analysis relative to claim exposures, Prepares findings of fact and other documentation required by the CO. Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models. Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred. Submit resumes and project list in MS Word or PDF format: Please No Calls
    $58k-101k yearly est. 60d+ ago
  • Stop Loss & Health Claim Analyst

    Sun Life Financial 4.6company rating

    Claim processor job in Baltimore, MD

    Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026
    $54.9k-82.4k yearly Auto-Apply 19d ago
  • Subrogation Claims Specialist

    Maryland Automobile Insurance Fund 4.1company rating

    Claim processor job in Baltimore, MD

    Maryland Auto Insurance is a Property & Casualty Insurance carrier and independent agency of the State of Maryland. We're located in the Locust Point neighborhood of Baltimore, featuring a variety of restaurant and shopping options in walking distance from the office. This position is ideal for candidates who desire flexible work schedules. The incumbent will be required to come into the office a minimum of two days per month. We offer an excellent benefit package including comprehensive health and dental coverage, pension plan, 401(k) plan and incentive program tied to strategic corporate and departmental goals. Generous leave package, tuition reimbursement and free onsite parking available. This role is open to applicants residing in Maryland, Delaware, Pennsylvania, or New Jersey. Position Summary This position will be responsible for recovering monies due to Maryland Automobile Insurance from responsible parties, including uninsured motorists and insurance companies. The Subrogation Specialist will manage a steady case load of Subrogation files. The Subrogation Specialist may manage arbitration and be responsible for recovery of consumer subrogation claims. Essential Functions: Negotiate payment in full, settlement in full, or a payment plan Attend hearings, mediations, settlement conferences, pre-trial hearings and fraud trials. Pursue applicant arbitration, defend respondent arbitration and counter claims. Competencies: Strong written and verbal negotiation skills required. Experienced, professional and creative writing skills and the ability to effectively communicate and persuade by printed word. Must demonstrate the ability to write a professional contention. Strong negotiation skills Ability to work independently and professionally. Professional demeanor and dependability. Accuracy and attention to detail. Critical thinker Exercise considerable independent judgment Strong organizational skills and the ability to prioritize and multi-task PC skills required Basic math skills Ability to be receptive and responsive to change and to embrace continuous improvement. Qualifications Education & Experience: High School Diploma or GED and 8 years of experience in automobile claims, automobile appraisal, law enforcement, or work involving conducting investigations or equivalent combination of education & experience. Subrogation and/or Arbitration experience preferred. Maryland Auto Insurance is a drug-free workplace and an equal opportunity employer, committed to diversity in the workplace. We do not discriminate on the basis of race, color, religion, age, sex, marital status, national origin, physical or mental disability, familial status, genetic information, gender identity or expression, sexual orientation, or any other characteristic protected by State or federal law. Applicants who need an ADA accommodation for an interview should request the accommodation when notified of a request to be interviewed. Applicants must be United States citizens or eligible to work in the United States.
    $58k-85k yearly est. 15d ago
  • Claims Analyst I

    Healthcare Legal Solutions LLC

    Claim processor job in Washington, DC

    JOB TITLE: Claims Analyst This position is responsible for assisting with following up on administrative appeals and documentation submitted to health insurers and governmental payers; working well with attorneys and paralegals; maintaining the workload. DUTIES AND RESPONSIBILITIES: Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue. Determines action required to resolve the underpayment and initiate that action, including submitting appeals and reconsideration requests. Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement Quickly and efficiently prepares, reviews, and submits well-written claims correspondence and related documents to insurers Is skilled, aggressive, cordial, and professional on the telephone to follow up on submitted appeals. Performs other related duties as assigned by management. QUALIFICATIONS: Bachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience. Other skills required : BA/BS with a GPA of 3.0 or higher. Interest in healthcare and healthcare law. Able to navigate through various computer systems and applications to find information about insurance claims. Ability to prioritize and multi-task. Excellent written and verbal communication skills. Proficiency in Microsoft Office, including Word and Excel. Excellent organizational and time management skills. High attention to detail. Clear, concise, and logical writing style. COMPETENCIES: Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures. Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals. Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values. External Working Relationships - Develops and maintains courteous and effective working relationships with clients, vendors and/or any other representatives of external organizations. Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
    $45k-80k yearly est. Auto-Apply 60d+ ago
  • Junior Travel Claims Analyst

    Seneca Holdings

    Claim processor job in Washington, DC

    Great Waters Federal is part of the Seneca Nation Group (SNG) portfolio of companies. SNG is Seneca Holdings' federal government contracting business that meets mission-critical needs of federal civilian, defense, and intelligence community customers. Our portfolio comprises multiple subsidiaries that participate in the Small Business Administration 8(a) program. To learn more about SNG, visit the website and follow us on LinkedIn. Our team of talented individuals is what makes us successful. To support our team, we provide a balanced mix of benefits and programs. Your total rewards package includes competitive pay, benefits, and perks, flexible work-life balance, professional development opportunities, and performance and recognition programs. We offer a comprehensive benefits package that includes medical, dental, vision, life, and disability, voluntary benefit programs (critical illness, hospital, and accident), health savings and flexible spending accounts, and retirement 401K plan. One of our fundamental principles is to offer competitive health and welfare benefits to our team members, providing coverage and care for you and your family. Full-time employees working at least 30 hours a week on a regular basis are eligible to participate in our benefits and paid leave programs. We pride ourselves on our collaborative work environment and culture, which embraces our mission of providing financial and non-financial benefits back to the members of the Seneca Nation. Great Waters Federal is seeking a Junior Travel Claims Analyst to support one of our government customers. Roles and Responsibilities include, but are not limited to: Receiving, reviewing, and authorizing travel requests Reviewing and processing travel vouchers Ensuring travelers' compliance with the Federal Travel Regulation and the agency's travel policy in all transactions Supporting travelers who are making and booking their own travel arrangements Providing customer support by phone, email and through an automated help desk system Tracking workload volume and supporting performance metrics reporting Basic Qualifications: Bachelor's degree OR HS diploma plus two years of relevant work experience (e.g., federal claims process, federal travel, or finance compliance) Excellent customer service and attention to detail Strong written and verbal communication skills Demonstrated ability to manage multiple tasks and priorities in a fast-paced environment while consistently meeting deadlines Desired Skills: Experience coordinating travel from pre-travel authorization through voucher approval Familiarity with the Federal Travel Regulation Equal Opportunity Statement: Seneca Holdings provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex/gender, sexual orientation, national origin, age, disability, marital status, genetic information and/or predisposing genetic characteristics, victim of domestic violence status, veteran status, or other protected class status. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation and training. The Company also prohibits retaliation against any employee who exercises his or her rights under applicable anti-discrimination laws. Notwithstanding the foregoing, the Company does give hiring preference to Seneca or Native individuals. Veterans with expertise in these areas are highly encouraged to apply.
    $45k-80k yearly est. Auto-Apply 60d+ ago
  • Claims Processor (remote) Iowa ONLY

    Cognizant 4.6company rating

    Claim processor job in Washington, DC

    **Claims Processing - Remote** for Iowa resident candidates Join our team as a Claims Processing Executive in the healthcare sector where you will utilize your expertise in MS Excel to efficiently manage and process commercial claims. This remote position offers the flexibility of working from home during day shifts allowing you to balance work and personal commitments effectively. Your contributions will directly impact the accuracy and efficiency of our claims processing enhancing customer satisfaction and operational excellence. _You will report to our office in Des Moines, Iowa for part of our training regimen._ **Key Responsibilities-** + _Claims Processing:_ Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies. + _Eligibility Verification:_ Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans. + _Adjudication:_ Approve, deny, or adjust claims based on payer guidelines and policy terms. + _Compliance:_ Maintain adherence to HIPAA regulations, CMS guidelines, and other US healthcare compliance standards. + _Documentation:_ Record claim activity, maintain audit trails, and prepare reports for management. **Required Skills & Qualifications-** + High school diploma or equivalent REQUIRED + Strong knowledge of US healthcare insurance systems (Medicare, Medicaid, commercial payers). + 2-4 years of experience in US healthcare claims processing + Familiarity with claims management software and EDI transactions. + Excellent analytical, organizational, and communication skills. + Ability to interpret insurance policies and payer guidelines. + Detail-oriented with strong problem-solving abilities. _Competencies-_ + Regulatory Knowledge - Deep understanding of US healthcare laws and payer requirements. + Accuracy & Detail Orientation - Ensures claims are processed correctly and efficiently. + Problem-Solving - Resolves claim disputes and denials effectively. **Salary and Other Compensation:** Applications will be accepted until January 30, 2025.The hourly rate for this position is between $16.00 - 17.00 per hour, depending on experience and other qualifications of the successful candidate.This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans. **Benefits:** Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:- Medical/Dental/Vision/Life Insurance- Paid holidays plus Paid Time Off- 401(k) plan and contributions- Long-term/Short-term Disability- Paid Parental Leave- Employee Stock Purchase Plan _Disclaimer:_ The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law. Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
    $16-17 hourly 16d ago
  • Experienced Outside Property Claim Representative - Washington, DC

    Msccn

    Claim processor job in Washington, DC

    ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers . If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 This position could be eligible for a sign on bonus. LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. What Will You Do? Handles 1st party property claims of moderate severity and complexity as assigned. Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. Broad scale use of innovative technologies. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. Establishes timely and accurate claim and expense reserves. Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. Writes denial letters, Reservation of Rights and other complex correspondence. Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. Meets all quality standards and expectations in accordance with the Knowledge Guides. Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. Manages file inventory to ensure timely resolution of cases. Handles files in compliance with state regulations, where applicable. Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. May provides mentoring and coaching to less experienced claim professionals. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. Must secure and maintain company credit card required. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. Perform other duties as assigned. Additional Qualifications/Responsibilities What Will Our Ideal Candidate Have? Bachelor's Degree preferred. General knowledge of estimating system Xactimate preferred. Two or more years of previous outside property claim handling experience preferred. Interpersonal and customer service skills - Advanced Organizational and time management skills- Advanced Ability to work independently - Intermediate Judgment, analytical and decision making skills - Intermediate Negotiation skills - Intermediate Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate Investigative skills - Intermediate Ability to analyze and determine coverage - Intermediate Analyze, and evaluate damages -Intermediate Resolve claims within settlement authority - Intermediate Valid passport preferred. What is a Must Have? High School Diploma or GED required. A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required. Valid driver's license required.
    $67k-110.6k yearly 19d ago
  • Chinese Triage Examiner

    Leidos 4.7company rating

    Claim processor job in Bethesda, MD

    The National Solutions Sector is currently looking experienced Chinese Triage Examiners in various languages to perform media exploitation (MEDEX) and triage in support a customer in the National Capital Region (NCR). Triage Examiners should be experienced in general linguist operations and Document and Media Exploitation (DOMEX) operations, and are expected to leverage language and analytical skills, as well as advanced computer systems aptitude in addressing triage examination projects. Triage Examiners will perform eDiscovery examinations of electronic media for content of interest using a suite of forensic examination tools and will identify and prioritize items of importance for further processing, in accordance with customer standard operating procedures. Examiners will also be expected to communicate effectively and provide ad-hoc notification to superiors on task progress and significant findings, and to produce a report of their findings for further dissemination to customer(s). Required Language: Chinese Locations: The NMEC-LEaRN program is located at the customer site in Bethesda, MD, and we also offer the option to work from different locations (JIRC sites). The primary responsibilities of the Triage Examiners are: Perform data discovery on large datasets of foreign language material and identify essential elements of information. Convert, reformat, parse, and otherwise exploit media files using customer tools to ensure compatibility and readability for translation systems. Prepare files and metadata for transfer to translation systems, including review of foreign-language data. Produce report of findings and disseminate to customer, analysts, and liaison officers. Prepare accurate written gists, translations, and/or transcriptions of general and technical material. Candidate must have operational experience within the Chinese language. Basic Qualifications Must have the sufficient language skills, analytic skills, and technical aptitude to gain proficiency with job-required tools and processes (On-the-job training may be provided as needed to address customer-specific needs, with ongoing evaluations throughout train-up period). Native-level proficiency in English. Two years of overall experience in Chinese linguist operations (i.e. translation, language analysis), and two years of experience performing media examination for Document and Media Exploitation projects. Willingness to perform occasional shift work to meet mission demands. Achieve a minimum score of a 3/3 in Reading and Listening in Chinese and 3+/3+ for Reading and Listening in English. BA degree and/or 4 years prior relevant experience in lieu of degree, or Masters with 2 years of prior relevant experience. Ability to compose summarizations of highly technical and complex subjects that are both succinct and accessible to a general reader. Outcomes-based problem solving of ill-defined and abstract problems. Ability to maintain project momentum while working independently with limited oversight over a long period of time. Ability to quickly scan and process a large amount of material in a foreign language for essential elements of information. Ability to comprehend customer prioritization requirements and apply them to files under review, as well as apply personal judgment when assessing the potential value of files and information. Demonstrated history of working on screening or translation projects and in maintaining the integrity and meaning of the translated material. Demonstrated ability to communicate in a professional manner (email, spoken, & reports). Ability to make sound decisions and handle stress, while meeting deadlines and performing in a high-paced environment. Familiarity with report writing styles for DOD and IC consumers. Possess a working proficiency in standard computer systems and office programs, with additional experience in media examination tools. Ability to use or train to proficiency on customer specific software programs and tools. Clearance Must currently possess at least an active TS/SCI clearance. Current or recent SCI-level access is a significant advantage and preferred. Must be able to pass a polygraph and Subject Interview. Preferred Qualifications Native-level proficiency in foreign language Graduate of the Defense Language Institute Chinese Course. An advanced degree in one of the following fields: Engineering, Computer Science, Chemistry, Physics, Legal, Medical, Banking and Financing, Foreign Military, Forensics Familiarity with Digital Forensics/eDiscovery/Document and Media Exploitation (DOMEX) processes and specialized tools (i.e. FTK, en Case, or similar). Past performance as a media examiner in support of DOD or IC customers. If you're looking for comfort, keep scrolling. At Leidos, we outthink, outbuild, and outpace the status quo - because the mission demands it. We're not hiring followers. We're recruiting the ones who disrupt, provoke, and refuse to fail. Step 10 is ancient history. We're already at step 30 - and moving faster than anyone else dares. Original Posting:August 26, 2025 For U.S. Positions: While subject to change based on business needs, Leidos reasonably anticipates that this job requisition will remain open for at least 3 days with an anticipated close date of no earlier than 3 days after the original posting date as listed above. Pay Range:Pay Range $73,450.00 - $132,775.00 The Leidos pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.
    $73.5k-132.8k yearly Auto-Apply 60d+ ago
  • Claims Specialist-WC

    Crawford & Company 4.7company rating

    Claim processor job in Fairfax, VA

    Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Documents and monitors open case inventory and ensures proper and timely closing of files. Makes decisions on claims within delegated limited authority.
    $52k-70k yearly est. Auto-Apply 1d ago
  • Claims Specialist

    Corvel Career Site 4.7company rating

    Claim processor job in Baltimore, MD

    The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a Hybrid role reporting to White Marsh, MD. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Requires regular and consistent attendance Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”) Additional projects and duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice Ability to identify, analyze and solve problems Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to meet or exceed performance competencies Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Minimum of 1 year of industry experience and claims management preferred State Certification as an Experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $51.8k-83.6k yearly 60d+ ago
  • Claims Analyst/Lead Claims Analyst/Senior Claims Analyst (Full-Time)

    McDonough Bolyard Peck, Inc. (Mbp

    Claim processor job in Vienna, VA

    MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar. Responsibilities Main Duties: Performs review and analysis of construction claims. Assists with development of contractor claims. Develops and/or review time extension requests. Assist with development of expert reports and exhibits. Qualifications Education B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree. P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred. Skills and Abilities Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Experience drafting expert reports and deliverables. Proficient in Oracle P6 required and experienced with Microsoft Project desired. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration. Ability to relate technical knowledge to a non-technical audience. Proficiency in reading/understanding construction plans and specifications. Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint. Experience providing training, supervision, proposal development, and business development desired. Occasional overnight travel may be required. STATUS: Full-time BENEFITS: Competitive compensation with opportunities for semi-annual bonuses Generous Paid Time Off and holiday schedules 100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual) Health Savings Account with company contribution 401(k)/Roth 401(k) plan with company match Tuition Assistance and Student Loan Reimbursement Numerous Training and Professional Development opportunities Wellness Program & Fitness Program Reimbursement Applicants must be authorized to work in the U.S. without sponsorship. MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.
    $42k-73k yearly est. Auto-Apply 2d ago
  • Claims Analyst - Construction Project

    Cornerstone Concilium

    Claim processor job in Baltimore, MD

    The Claims Analyst will perform a variety of "changes and claims" related contract administration tasks. An ideal candidate requires experience in transit projects through design, construction and commissioning phases. The Claims Analyst will be responsible for coordinating and reviewing claims / changes and engaging, strategizing, and working with various Program / Project teams to undertake the merit assessment, mitigation, and resolution of claims. The role requires commercial claim knowledge, and preferably also technical understanding, of multiple subject areas related to implementation of a large transit infrastructure projects. Responsibilities Maintain claims and early warnings' register. Review alleged claims. Carry out initial triage and risk assessment of claims. Review project correspondence, and track and report on project claims. Interface with the contractor and other stakeholders, as required, to gather additional details etc. Attend various technical and commercial project working group meetings. Requirements Required Skills: Critical thinking skills sufficient to apply analytical techniques to assess claims. The ability to liaise effectively and to work closely with various multi-disciplinary technical and project controls teams Proficiency with Microsoft Office Suite, particularly Excel. Strong organization, time management, and prioritization skills with proven ability to balance competing tasks and meet deadlines. Self-directed, detail-oriented, excellent at meeting deadlines with well-developed time management skills. Excellent communication (both written and verbal), teamwork, and interpersonal skills. Required Qualifications: Bachelor's degree in engineering, business or other relevant degree. 1 - 4 years of relevant experience Position Location Field: Hybrid - 2 or 3 days in program office
    $35k-63k yearly est. 60d+ ago

Learn more about claim processor jobs

How much does a claim processor earn in Rockville, MD?

The average claim processor in Rockville, MD earns between $29,000 and $83,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Rockville, MD

$49,000
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