Claims Examiner. Workers' Comp
Claim processor job in Columbia, MD
Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connectingpeople to the work that matters since 1988. We provide meaningful opportunitiesto our extensive network of healthcare and school-based professionals, ready towork in any hospital, government facility, or school. Through partnership andinnovation, Amergis creates unmatched staffing experiences to deliver the bestworkforce solutions.
The Claims Examiner Workers' Comp understands and participates in every aspect of the WC claim process. Working in a team approach, the Claims Examiner WC will make decisions concerning reserve adjustments, develop a plan of action, and determine claim resolution. The Claims Examiner WC also works with the Adjusters, WC Manager, and fellow Amergis team members.
Essential Duties and Responsibilities:
+ Manages full cycle claim management for assigned states to resolution
+ Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees in order to communicate status plans
+ Ensures legal deadlines are met
+ Monitors TPA's file resolution plans
+ Represents Amergis in depositions, mediation, and conference calls regarding assigned claim files
+ Provides analysis on the financial aspects of assigned claims files
+ Provides excellent customer service to injured workers
+ Prepares WC claim reports for department management team
+ Reviews, identifies and makes recommendations for maintaining control and/or reducing the claims experience (loss history) of the company
+ Authorizes or revise reserve requests
+ Coordinates with Benefits team during employee's absence
+ Coordinates with state programs and internal departments for transitional duty
+ Educates branch offices about all aspects of Workers' Compensation
+ Assists Manager in achieving overall department goals
+ Performs other duties as assigned/necessary
Minimum Requirements:
+ College degree preferred; or equivalent work experience
+ 5 to 10 years of Workers' Compensation experience preferred
+ Some legal experience strongly preferred
+ Good organizational skills and attention to detail
+ Ability to work independently and cooperatively in a team environment
+ Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization
+ Computer proficiency, including Microsoft Office applications, required
+ Prior experience performing internet research
+ Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language is required
At Amergis Healthcare Staffing, wefirmly believe that our employees are the heartbeat of our organization and weare happy to offer the following benefits:
Medical/Prescription,Dental, Vision, Health Advocacy (company paid if enrolled Medical), HealthAdvocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability,Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death and Dismemberment Insurance, Voluntary Life and Accidental Death and DismembermentInsurance, Hospital Expense Protection Plan, Critical Illness Insurance,Accident Insurance, Dependent Care Flexible Spending Account, Home and AutoInsurance, Pet Insurance, MilkStork, Transportation Benefit, EducationalAssistance Program, College Partnership Program, Paid Time Off/Company Holidays
*Benefit eligibility is dependent onemployment status.
AmergisHealthcare Staffing is an equal opportunity/affirmative action employer. Allqualified applicants will receive consideration for employment without regardto sex, gender identity, sexual orientation, race, color, religion, nationalorigin, disability, protected Veteran status, age, or any other characteristicprotected by law.
This posting willremain active on job boards for 5 days from date of posting unless there is agood faith basis to extend the posting date.
Please note thatthis pay range represents a good faith estimate of the compensation that willbe offered for this position based on the circumstances. The actual pay offeredto a successful candidate will take into account a wide range of factors,including but not limited to location, experience, and other variable factors.
"Pursuant tothe San Francisco Fair Chance Initiative, Amergis will consider for employmentqualified applicants with arrest and conviction records"
Claims Processor - Entry Level (BS Degree Required)
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.
Claims Examiner
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
Claims Examiner - Auto/Bodily Injury
Claim processor job in Alexandria, VA
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Claims Examiner - Auto/Bodily Injury
**PRIMARY PURPOSE** : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
+ Responsible for litigation process on litigated claims.
+ Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
+ Reports large claims to excess carrier(s).
+ Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
+ Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.
**Experience**
Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
**Skills & Knowledge**
+ In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws
+ Knowledge of medical terminology for claim evaluation and Medicare compliance
+ Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
+ Strong oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Strong organizational skills
+ Strong interpersonal skills
+ Good negotiation skills
+ Ability to work in a team environment
+ Ability to meet or exceed Service Expectations
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical:** Computer keyboarding, travel as required
**Auditory/Visual:** Hearing, vision and talking
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $75,000_ _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Experienced Outside Property Claim Representative
Claim processor job in Washington, DC
**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?**
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.
**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.
**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 ******************************************************** .
Senior Claims Analyst
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
Stop Loss & Health Claim Analyst
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
Auto-ApplyClaims Analyst I
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.
Auto-ApplyExperienced Outside Property Claim Representative - Washington, DC
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.
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
What Is the Opportunity?
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.
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.
Chinese Triage Examiner
Claim processor job in Bethesda, MD
Job Description
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 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.
Program NameProgram Name
LEaRN
AttachmentsBusiness Process History
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:November 14, 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.
Auto-ApplySubmarine Certification Specialist - Washington, D.C.
Claim processor job in Washington, DC
Looking for an opportunity at a place you can have influence and make a difference every day? Then Serco has the right opportunity for you! As the Program Analyst (Submarines), you will provide programmatic support to one of our NAVSEA customers in the Washington, DC area. Bring your expertise and collaborative skills to make an impact towards our military defense and safety of our sailors.
Serco is the prime on the SHAPM contract which deals with acquisition and construction of submarines. The Team Submarine concept unifies once diverse submarine-related activities into a single submarine-centric organization with the goal of eliminating traditional stovepipe structures and processes that created impediments and inefficiencies in the submarine research, development, acquisition, and maintenance communities. Team Submarine provides improved communication among the various offices that contribute to the overall success of the United States Submarine Force.
**In this role, you will:**
+ Provide Engineering and Technical support coordinating all matters relating to preparation, review and approval of Ship Certification correspondence for Fast Cruise and Sea Trials, Follow-On certifications and URO certifications.
+ Coordinate routing and processing of all ship certification documents for concurrence and approval signatures.
+ Prepare coordinated reports, presentations and briefings in support of program actions.
+ Analyzes requirements to develop program reporting including specifications, data gathering and analytical techniques, and evaluation methodology.
+ Support studies, surveys, reviews, and/or research projects to evaluate program accomplishments, effectiveness, and/or compliance with meeting specific goals, objectives, rules, and regulations.
+ Develop evaluation plans, metrics, procedures, and methodology as a result of studies performed.
+ Provide Subject Matter Expert (SME) support and assist the Government with technical analyses, inquiries, research, testing, data validation for any matters relating to US submarines.
+ Maintain applicable Plans of Actions and Milestones (POA&M) as directed/required.
+ Interface with stakeholders to identify, assign, and track action items, leveraging initiatives to benefit submarine sustainment support.
+ Collect information and provide recommendations to senior decision-makers through well-written documents.
+ Communicate with various Program Office representatives within NAVSEA and other Department of Navy organization in supporting PM concerns.
+ Coordinate with the technical community and develop white papers and presentations for the Government and the Navy on program status or issues impacting the program.
+ Organize and maintain Program tracking files/tools on program status, actions items and issues.
+ Support the team in performing additional duties and responsibilities as assigned.
+ Provide timely and efficient responses for all urgent tasking.
+ Ensure program correspondence and deliverables are in accordance with Serco's Quality Assurance Program.
Meet Your Recruiter! (https://serco.kzoplatform.com/player/medium/**********002817285?embed=true&layout=fullscreen&overlay=false&auth=public)
**Qualifications**
**To be successful in this role you will have:**
+ Ability to obtain and maintain an active DoD Secret clearance.
+ US Citizenship
+ Bachelor's Degree
+ An Associate's Degree and 2 years of additional experience will be considered in lieu of Bachelor's Degree or a High School Diploma/GED and 4 years of additional experience will be considered in lieu of Bachelor's Degree.
+ 8 years of experience (Experience with Navy acquisition and/or In-Service Programs highly preferred)
+ Strong customer, interpersonal and organizational level communication skills (written and verbal).
+ Proficiency with Microsoft Office Suite programs, to include Excel and PowerPoint.
+ Written communication skills (e.g., drafting program impact statements and Congressional Appeals)
+ Experience leading a project and interfacing with an end item customer.
+ Ability to travel at least 10% of the time.
**Additional desired experience and skills:**
+ Active-Duty experience in submarine service (preferably SSN) is a plus.
+ Recent experience in Team Submarine would be ideal.
If you are interested in supporting and working with our military and sailors and a passionate Serco team- then submit your application now for immediate consideration. It only takes a few minutes and could change your career!
**Company Overview**
Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco's 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.
To review Serco benefits please visit: *********************************************************** . If you require an accommodation with the application process please email: ******************** or call the HR Service Desk at ************, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see our Applicant Privacy Policy and Notice (**************************************** .
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email ********************* .
Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
**Pay Transparency**
Our Total Rewards package includes competitive pay, performance-based incentives, and benefits that promote well-being and work-life balance-so you can thrive both professionally and personally. Eligible employees also gain access to a wide range of benefits from comprehensive health coverage and health savings accounts to retirement plans, life and disability insurance, and time-off programs that support work-life balance. Program availability may vary based on factors such as contract type, location, hire date, and applicable collective bargaining agreements.
Salary range: The range for this position can be found at the top of the posting. This range is provided as a general guideline and represents a good faith estimate across all experience levels. Actual base salary will be determined by a variety of factors, including but not limited to, the scope of the role, relevant experience, job-related knowledge, education and training, key skills, and geographic market considerations. For roles available in multiple states, the range may vary to reflect differences in local labor markets. In addition to base salary, eligible positions may include other forms of compensation such as annual bonuses or long-term incentive opportunities.
Benefits HIGHLIGHTS - Comprehensible Benefits for Full-time Employees (Part-time members receive a customized package tailored to their role).
+ Medical, dental, and vision insurance
+ Robust vacation and sick leave benefits, and flexible work arrangements where permitted by role or contract
+ 401(k) plan that includes employer matching funds
+ Tuition reimbursement program
+ Life insurance and disability coverage
+ Optional coverages you can buy, including pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection
+ Birth, adoption, parental leave benefits
+ Employee Assistance Plan that includes counseling conditions
+ Specific benefits are dependent upon the specific contract as well as whether the position is covered by a collective bargaining agreement or the Service Contract Act.
To review all Serco benefits please visit: ***************************************** .
Serco complies with all applicable state and local leave laws, including providing time off under the Colorado Healthy Families and Workplaces Act for eligible Colorado residents, in alignment with our policies and benefit plans. The application window for this position is for no more than 60 days. We encourage candidates to apply promptly after the posting date, as the position may close earlier if filled or if the application volume exceeds expectations. Please submit applications exclusively through Serco's external (or internal) career site. This is a U.S.-based role. If an applicant has any concerns with job posting compliance, please send an email to: ******************** .
Click here to apply now (**************************************************************************************************************************************************************
**New to Serco?**
Join our Talent Community! (***************************************************
**ID** _72127_
**Recruiting Location : Location** _US-DC-Washington_
**Category** _Project/Program Management_
**Position Type** _Full-Time_
**Security Clearance** _Other_
**Clearance Details** _Ability to obtain and maintain an active DoD Secret clearance._
**Telework** _No - Teleworking not available for this position_
**Campaign** _LPMETS_
**Salary Range/Amount** _$103369.00 - $167974.00_
Easy ApplyClaims Specialist
Claim processor job in Columbia, MD
Job Description
Job Title: Claims Specialist
Reporting to: Director of Project Management
Company: Tate
About Us
At Tate, we are passionate about everything we do. As an independent brand operating within Kingspan Group, a global plc group of companies, Tate has been recognized worldwide as an industry leader in the development and manufacture of data center infrastructure solutions and commercial office raised access floors, for over 60 years. With revenues of over $420m and growing, Tate plays a pivotal role in offering expertise in cutting edge design engineering to craft solutions, by working collaboratively with clients as a trusted partner.
Tate continues to grow and expand, operating multiple manufacturing and commercial sites across the US, Europe, the Middle East, Asia, and Australia. We are excited about our fresh, dynamic, and inclusive team of experts working on new innovations and forward-thinking designs, as we remain a market leading player within our industry. We continue to invest heavily in the best available manufacturing tools and equipment needed to adhere to Tate's world class standards and in keeping with our Planet Passionate sustainability strategy, our focus is on having minimal climate impact.
We are excited to potentially welcome you as part of our team as we continue to grow on a worldwide scale.
About the Role
We are seeking a highly organized and customer-focused Claims Specialist to manage and resolve customer claims with precision and empathy. In this role, you will serve as the primary point of contact for customers, ensuring claims are logged, tracked, and resolved efficiently while collaborating across Manufacturing, Finance, and Customer Service teams. The ideal candidate will use strong analytical, project management, and communication skills to drive root cause analysis, implement corrective actions, and enhance the overall customer experience.
What You'll Do
Log, track, and manage customer claims in Salesforce from initiation to resolution.
Communicate empathetically with customers, providing timely updates throughout the claims process.
Collaborate with Manufacturing, Finance, and other internal teams to investigate claims and implement resolutions.
Facilitate cross-functional meetings and follow up on corrective actions to ensure accountability.
Identify trends in claims, perform root cause analysis, and recommend process improvements.
Provide regular reports on claim volume, resolution times, root causes, and customer impact.
Additional Expectations
Maintain accurate and thorough documentation of all claims, communications, and outcomes.
Escalate complex issues appropriately and ensure follow-through on resolutions.
Uphold a high standard of service excellence in every customer interaction.
Support continuous improvement initiatives by analyzing data and providing actionable insights.
Manage multiple priorities effectively while maintaining attention to detail and quality.
What You'll Bring
Bachelor's degree in business, Project Management, or a related field.
3+ years of experience in customer service, claims resolution, or project coordination.
Proficiency in Salesforce, Excel, and data analysis tools.
Excellent communication, problem-solving, and organizational skills.
Ability to drive cross-functional collaboration and manage multiple priorities.
Preferred: experience in manufacturing or B2B environments, familiarity with root cause analysis frameworks (e.g., 5 Whys, Fishbone), exposure to corrective action planning, and project management certification (CAPM or PMP).
Employee Benefits
Career Scope and Advancement: As we grow, new positions and career opportunities arise, offering accelerated paths for the right candidates, locally and globally.
World of Wellness Philosophy: We empower you to take charge of your health and well-being. You'll have access to a wide range of medical, dental, and vision benefits, along with personalized guidance from a “Health Advocate.” We also offer other supplemental options, including 401k, legal, disability, and theft insurance, to ensure your financial wellness.
Corporate Social Responsibility: Through Planet Passionate we are determined to reduce our manufacturing carbon (CO2e) emissions to as close to zero as technically possible, together with halving carbon intensity in our primary supply chain. We are very involved in our community, and you will have ample opportunities to support us in creating a better world.
Skills Development: Given the dynamic pace of our business and a strong collaborative environment, your new role will be diverse and multifaceted - allowing you to be more versatile and develop a broader skill set.
Mentorship and development: At Tate, we don't believe in hierarchy; we work together as one team for one common goal. You will have access and exposure to our senior leaders and experts for learning in your role, and additional mentorship for the future.
Culture: We have a great team of culture, highly collaborative, supportive, and social skills. Together we innovate, collaborate, take ownership, and strive for excellence.
Tate
is an equal opportunity for employers. We encourage applications from candidates of all backgrounds and experiences.
Stay connected with us on
LinkedIn
for insights into life at Tate. Join us in our mission to make a difference through exceptional solutions.
Experienced Outside Property Claim Representative
Claim processor job in Washington, DC
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 CategoryClaimCompensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range$67,000.00 - $110,600.00Target Openings1What Is the Opportunity?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.
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.
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 *********************************************************
Auto-ApplyClaims Specialist
Claim processor job in Rockville, 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.
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
Claims Analyst/Lead Claims Analyst/Senior Claims Analyst (Full-Time)
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.
Auto-ApplyClaims Analyst
Claim processor job in Washington, DC
Job Description
Role: Claims Analyst
Status: Full-time
Mission: To allow frail elderly people to age in the location of their choosing and continue to lead connected, meaningful lives
JOB SUMMARY
The Claims Analyst reviews, processes and analyzes healthcare claims to determine their validity and accuracy. They assess damages, verify policy coverage and ensure compliance with regulations and company procedures. Effective communication, problem-solving and attention to detail are crucial for this role.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Reviews submitted claims for accuracy, completeness and adherence to policy terms and legal requirements.
Analyzes claim data to identify trends, patterns, and potential irregularities.
Communicates with stakeholders to gather information, explain decisions, and resolve issues.
Investigates potential fraudulent claims and gathering supporting evidence.
Makes informed decisions on claim validity and determining appropriate compensation.
Maintains accurate and detailed records of claims processing and outcomes.
Ensures adherence to relevant regulations and company policies.
Develop and maintain positive relationships with the network of providers through ongoing
communication and by providing feedback
Performs other duties as required.
QUALIFICATIONS
Education and Experience:
High School Diploma. Associate's Degree preferred.
1-3 years of experience in data analysis in a customer service environment within the healthcare insurance industry preferred.
Experience analyzing data, identifying discrepancies and making informed decisions.
Skills and Competencies:
Able to clearly explain complex information, both verbally and in writing.
Able to identify and resolve issues related to claims processing.
Strong attention to detail to ensure accuracy in claim review and data entry.
Knowledge of Insurance/Healthcare, including understanding policy terms, coverage, and relevant regulations.
Exceptional customer service skills.
Learn more at:
edenbridgepace.com/dc
Claims Analyst/Forensic Scheduler
Claim processor job in Baltimore, MD
Do you thrive on uncovering the story behind project delays and turning data into defensible insights? Join PEMCCO as a Claims Analyst/Forensic Scheduler, where you'll perform detailed schedule and delay analyses to assess time and cost impacts on construction projects. In this role, you'll support dispute resolution and litigation preparation by developing clear, evidence-based findings and narrative documentation that stand up to scrutiny.
PEMCCO, Inc. is an Information Technology and Information Management (IT/IM) services firm. We assist our customers in maximizing existing and emerging technologies to achieve their desired business productivity objectives. Living the Culture and Making It Happen is the motto we live by. We Live the Culture by carrying out the tenets of our Core Values of Loyalty, Integrity, and Commitment to our Customers and Employees every day. We Make It Happen by following Smart Organization Healthy Organization (SOHO) principles for internal and external communications and the successful execution of projects.
Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
Essential Functions
* Reconstruct as‑built schedules from field data, daily reports, and contractor updates.
* Perform critical path delay analysis, disruption quantification, and time‑impact modeling.
* Prepare expert‑level claims narratives with exhibits, graphics, and correlation charts.
* Support negotiations, mediations, and expert testimony preparation.
* Interface with project management, legal counsel, and technical advisors.
* Maintain a documentation library compliant with DGS and COMAR record‑keeping requirements.
Competencies
* Mastery of forensic scheduling, claims causation, and delay quantification.
* Excellent analytical, research, and report‑writing skills.
* Familiarity with contract law, AIA, and MD GMP provisions, and time‑extension protocols.
Required Qualifications
* Bachelor's degree in Engineering, Construction, or related field.
* 10+ years of schedule or claims analysis experience, including public capital programs.
* Must pass client background screening and security clearance.
Preferred Qualifications
* AACE CFCC or PSP certification.
* Experience in forensic schedule analysis for DGS, MDOT, or SHA.
Benefits
* 15 days of Paid Time Off
* 11 Paid Holidays
* Medical, Dental, and Vision
* Voluntary Short-Term Disability, Life Insurance, Accident, Critical Illness, Hospital Indemnity, Whole Life Plus, Identity Theft, and Law Assure
* 401(k)
* Employee Assistance Program (EAP)
Compensation
* $145 - $175 hourly, depending on experience, ability, and capability.
The role requires full-time, on-site presence in Baltimore, MD. Candidates must be able to reliably commute; relocation expenses are not provided.
PEMCCO, Inc. is an equal-opportunity employer. The Company does not discriminate based on race, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, military or veteran status, pregnancy, childbirth, and related medical conditions, or any other characteristics protected by applicable federal, state, or local law.
Claims Analyst/Forensic Scheduler
Claim processor job in Baltimore, MD
Do you thrive on uncovering the story behind project delays and turning data into defensible insights? Join PEMCCO as a Claims Analyst/Forensic Scheduler, where you'll perform detailed schedule and delay analyses to assess time and cost impacts on construction projects. In this role, you'll support dispute resolution and litigation preparation by developing clear, evidence-based findings and narrative documentation that stand up to scrutiny.
PEMCCO, Inc. is an Information Technology and Information Management (IT/IM) services firm. We assist our customers in maximizing existing and emerging technologies to achieve their desired business productivity objectives. Living the Culture and Making It Happen is the motto we live by. We Live the Culture by carrying out the tenets of our Core Values of Loyalty, Integrity, and Commitment to our Customers and Employees every day. We Make It Happen by following Smart Organization Healthy Organization (SOHO) principles for internal and external communications and the successful execution of projects.
Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
Essential Functions
Reconstruct as‑built schedules from field data, daily reports, and contractor updates.
Perform critical path delay analysis, disruption quantification, and time‑impact modeling.
Prepare expert‑level claims narratives with exhibits, graphics, and correlation charts.
Support negotiations, mediations, and expert testimony preparation.
Interface with project management, legal counsel, and technical advisors.
Maintain a documentation library compliant with DGS and COMAR record‑keeping requirements.
Competencies
Mastery of forensic scheduling, claims causation, and delay quantification.
Excellent analytical, research, and report‑writing skills.
Familiarity with contract law, AIA, and MD GMP provisions, and time‑extension protocols.
Required Qualifications
Bachelor's degree in Engineering, Construction, or related field.
10+ years of schedule or claims analysis experience, including public capital programs.
Must pass client background screening and security clearance.
Preferred Qualifications
AACE CFCC or PSP certification.
Experience in forensic schedule analysis for DGS, MDOT, or SHA.
Benefits
15 days of Paid Time Off
11 Paid Holidays
Medical, Dental, and Vision
Voluntary Short-Term Disability, Life Insurance, Accident, Critical Illness, Hospital Indemnity, Whole Life Plus, Identity Theft, and Law Assure
401(k)
Employee Assistance Program (EAP)
Compensation
• $145 - $175 hourly, depending on experience, ability, and capability.
The role requires full-time, on-site presence in Baltimore, MD. Candidates must be able to reliably commute; relocation expenses are not provided.
PEMCCO, Inc. is an equal-opportunity employer. The Company does not discriminate based on race, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, military or veteran status, pregnancy, childbirth, and related medical conditions, or any other characteristics protected by applicable federal, state, or local law.
Claims Analyst - Construction Project
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
Senior Veterans Benefits Claims Analyst
Claim processor job in Haymarket, VA
Travel Requirement
Less than 10 percent.
VA Background Investigation Requirement
Candidate must hold or be eligible to undergo and pass a mandatory government background check.
Candidate must pass a pre-employment drug screening.
U.S. Citizenship may be required by certain federal customers.
Best Value Technology, Inc. (BVTI) is an established Service-Disabled Veteran-Owned Small Business (SDVOSB) with a 20-year track record delivering innovative data and technology solutions to the federal government.
BVTI is seeking an individual with strong experience in VBA Claims Processing to support an anticipated contract focused on delivering veteran benefits claims processing improvement efforts to programs within the Department of Veteran's Affairs. The candidate will provide subject matter expertise on VA disability compensation and/or pension claims processes, as well as VBA's documentation processes and workflows for these benefits. The candidate will also provide training and collaborate with Team Leaders supporting multiple project teams, providing direct support to the Department of Veterans Affairs, and contributing knowledge of VBA claims operations across various operational units. The ideal candidate will be a self-motivator who is attentive to details and possesses the training and problem-solving skills required to independently assess and advise a team, ensuring critical deadlines are met.