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  • Insurance Claims Specialist

    Marubeni America Corporation 4.6company rating

    Claim processor job in New York, NY

    To be considered, please apply through the link here. We are seeking an experienced and independent Insurance Claims Specialist with 7+ years of multi-line claims experience to manage and resolve claims across Marine Cargo, Property & Casualty, Automobile, Workers' Compensation, and Liability/Litigation. The role also supports contract reviews by assessing insurance-related provisions to ensure alignment with policy coverage and claims protocols. The ideal candidate will also provide support to the Insurance Manager and General Manager on special insurance projects as needed, contributing to broader departmental goals and demonstrating flexibility beyond core claims duties. ESSENTIAL JOB DUTIES: Manage the end-to-end claims process for: -Marine cargo/inland transit -Commercial property and general liability -Automobile (fleet and HNOA) -Workers' Compensation (“WC”) -Litigated liability claims, including bodily injury and third-party property damage Handle end-to-end claims for marine, property, liability, auto (fleet/HNOA), WC, and litigated matters including bodily injury and third-party property damage. Review policies to assess coverage, exclusions, deductibles, and retentions Coordinate with brokers, carriers, adjusters, and Internal legal counsel Support contract review by evaluating insurance clauses (limits, AI, Waiver of Subrogation) and identifying potential risk/coverage gaps Draft claim notifications and ensure compliance with policy timelines Provide loss history, reserve, and claim summaries to assist with renewal preparation Collaborate with Legal, MGC, and MAC BU Operations to resolve claims Participate in claim reviews and strategic discussions in recovery efforts Support the GM and Insurance Manager with special insurance-related projects as needed, and demonstrate flexibility in cross-functional assignments. MINIMUM EDUCATION REQUIREMENTS: Bachelor's degree in insurance or business-related fields or equivalent experience. MINIMUM EXPERIENCE AND CAPABILITY REQUIREMENTS: 7+ years of insurance claims experience across multiple P&C lines, including marine and litigated claims. Strong working knowledge of insurance policy language, ISO forms, and manuscript policies. Familiarity with contractual risk transfer principles and ability to analyze insurance-related clauses. Experience coordinating with external counsel and adjusters on complex/litigated claims. Proficiency in claims systems, Microsoft Word and Excel, and document management platforms. Technically skilled in both claims handling and policy interpretation. Detail-oriented with excellent judgment and risk awareness. Confident in reviewing contract language from an insurance perspective. Collaborative and able to communicate effectively with both technical and non-technical stakeholders. Able to manage competing priorities and operate independently. Must have the ability to work with deadlines and work in a fast-paced and dynamic work environment. Requires excellent written and verbal communication skills. Must be able to work in a multi-cultural business environment. JOB-RELATED CERTIFICATION: CPCU, ARM, or AIC designation preferred
    $46k-71k yearly est. 5d ago
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  • Claims Examiner Liability 1468569

    Adecco Us, Inc. 4.3company rating

    Claim processor job in Philadelphia, PA

    Adecco is assisting a local client recruiting General Liability Claims Analyst opportunities in Philadelphia, PA (Remote Role). This is an excellent opportunity to join a winning culture and get your foot in the door for being known Helping people, restoring property, preserving brands and empowering performance. If General Liability Claims Analyst sounds like something you would be interested in, and you meet the qualifications listed below, apply now! **Key Responsibilities** · To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **Required Skills** : · Analyze and process complex general liability claims by investigating and gathering information to determine exposure. · Develop and execute action plans to achieve timely and appropriate resolution of claims. · Assess liability and resolve claims within evaluation guidelines. · Negotiate settlements within designated authority. · Calculate and assign timely and appropriate reserves, monitor reserve adequacy throughout the claim lifecycle. · Approve and process timely claim payments and adjustments within authority limits. · Prepare and submit necessary state filings within statutory deadlines. · Manage litigation process to ensure timely and cost-effective resolution. · Coordinate vendor referrals for investigations and litigation management. · Utilize cost containment strategies, including strategic vendor partnerships, to reduce overall claim costs. · Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets. · Report claims to excess carriers and respond to requests promptly and professionally. · Maintain communication with claimants and clients; foster professional client relationships. · Ensure proper documentation and accurate coding of claim files. · Refer cases to supervisors or management as appropriate. What's in this General Liability Claims Analyst position for you? Pay: $ 35.71/hr. Shift: Remote Role // 8:00 AM-5:00 PM EST Mon- Fri // Philadelphia, PA Weekly paycheck Dedicated Onboarding Specialist & Recruiter · Access to Adecco's Aspire Academy with thousands of free upskilling courses. This General Liability Claims Analyst is being recruited by one of our Centralized Delivery Team and not your local Branch. For instant consideration for this General Liability Claims Analyst position and other opportunities with Philadelphia, PA(Remote Role) apply today! **Pay Details:** $35.71 per hour Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance **Massachusetts Candidates Only:** It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $35.7 hourly 1d ago
  • Pharmacy Claims Specialist

    Blinkrx

    Claim processor job in Pittsburgh, PA

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

    Vanguard Group Staffing, Inc.

    Claim processor job in New York, NY

    Long Term Temporary, Possible Temporary- to -Direct Hire Medical Billing/Claims Coordinator - Monday through Friday, 9am to 5pm, Fully On-Site. Communicate via telephone and written correspondence with providers, members, attorneys, and collection agencies to resolve balance billing/fee negotiation inquiries. Handle large call volume. Negotiate and resolve balance billing inquires, negotiate fees and discounts for members with nonparticipating providers to reduce out of pocket expenses. Analyze correspondence; verify member eligibility, claim history and coordination of benefits. Review claims to determine if appropriate action was taken; follow up with Claims and Recovery Units to initiate adjustments and recover money. Identify billing anomalies and alert the Fraud and Abuse Department to reduce fraudulent billing practices. Triage balance billing/fee negotiation inquiries and ensure all documents are processed in a timely and efficient manner. Research provider contracts and lease network reports to ensure providers are not breaching contracts by referring members out of network. Perform additional duties and projects as assigned by management.
    $39k-50k yearly est. 2d ago
  • Claims Representative, Auto Property Damage - Independent Agent Channel

    Plymouth Rock Assurance 4.7company rating

    Claim processor job in Parsippany-Troy Hills, NJ

    The Auto Property Damage Claims Representative is responsible for managing Auto Property Damage claims within our “Auto PD Claim Unit.” This role demands a high level of customer service, patience, and professionalism while working in a fast-paced environment with significant phone interaction. Strong customer service, organizational, verbal, and written communication skills are essential. The ability to navigate adversarial situations with professionalism is critical. Comparative negligence claim handling experience is a plus but not required. RESPONSIBILITIES Policy Analysis: Investigate and interpret policy provisions, endorsements, and conditions to determine coverage for automobile property claims. Identify and investigate contested coverage claims that may require a roundtable discussion. Claim Investigation: Investigate auto accidents to assess liability by interviewing first- and third-party claimants, witnesses, investigating officers, and other relevant parties. Secure and analyze pertinent records, documentation, and loss scene information to determine proximate cause, negligence, and damages. Claims Management: Evaluate and adjust reserves as necessary. Prepare dispatch instructions for field personnel to inspect vehicles. Negotiate and settle claims within individual authority limits and seek supervisor approval for claims exceeding authority or requiring additional guidance. Maintain effective follow-up systems on pending files, advising insureds, claimants, and brokers on claim status. Act as an intermediary between the company, preferred vendors, and customers to resolve disputes. Ensure adherence to privacy guidelines, laws, and regulations in claims handling. Subrogation and Legal Handling: Investigate and initiate subrogation processes when applicable. Handle and respond to special civil part lawsuits or intercompany arbitrations related to auto property damage claims. Administrative Duties: Manage a customer-focused phone environment by answering calls, returning voicemails, and responding to emails and text correspondence promptly. Process incoming and outgoing mail timely and in accordance with state guidelines. Complete other duties as assigned. QUALIFICATIONS Bachelor's degree required. A minimum of 1 year of related PD claim experience is welcomed but not required. Proficiency in personal computer skills, including Microsoft Office Suite. Ability to prioritize and manage multiple tasks effectively. Excellent communication, organizational, and customer service skills. SALARY RANGE The pay range for this position is $47,000 to $55,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. PERKS & BENEFITS 4 weeks accrued paid time off, 8 paid national holidays per year, and 2 floating holidays Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision) Annual 401(k) Employer Contribution Resources to promote Professional Development (LinkedIn Learning and licensure assistance) Robust health and wellness program and fitness reimbursements Various Paid Family leave options including Paid Parental Leave Tuition Reimbursement ABOUT THE COMPANY The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
    $47k-55k yearly 5d ago
  • Senior General Liability Claim Representative

    CWA Recruiting

    Claim processor job in Union, NJ

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

    Athens Administrators 4.0company rating

    Claim processor job in Parsippany-Troy Hills, NJ

    Details Claims Examiner I - Commercial Auto Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt in all state except California Job Grade: 9 Career Ladder: Next step in progression could include Claims Examiner II ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner I to support our Property & Casualty department. Employees who live less than 26 miles from the San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA, and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. The Claims Examiner I is responsible for the timely investigation, evaluation and determination of settlement or denial of minor to moderate multi-line auto property and casualty claims with a docus on trucking and property damage claims. They will be handling claims from inception to closure. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills. Investigate coverage, including evaluate insurance coverage problems and/or disputes Investigate, evaluate and determine settlement value or denial of liability for all claims Develop a measure of damage for each loss, establish and maintain appropriate reserves Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure Ensure appropriateness of all payments Negotiate settlement of claim within individual authority ($15,000 unless otherwise noted) Maintain and update action plans for each claim May assign and coordinate with vendors, legal counsel, appraisers or experts as necessary Facilitate between claimants, clients, brokers and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers Provide customer service and support to insureds and claimants Assist in training of new employees Attend meetings and educational seminars for professional development Maintain required licenses ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states Minimum of three years auto-claims handling experience, at least one-year commercial auto required Trucking experience preferred Knowledge of property and casualty insurance policies Knowledge of auto insurance laws, codes, procedures, and liability concepts Proficiency in investigation and resolution of minor to medium level auto physical damage casualty claims Strong negotiation skills and ability to achieve optimal settlement results for clients. Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here
    $51k-77k yearly est. 60d+ ago
  • Claims Specialist, APH

    Swiss Re 4.8company rating

    Claim processor job in Armonk, NY

    Imagine a role where you can directly influence the profitability of a business, steer a diverse portfolio of claims, and build lasting relationships with clients. If you're a self-motivated individual who thrives on collaboration and career growth, this challenge is for you! If this sounds interesting, join us at Swiss Re, where we believe in fostering an environment that sparks the best ideas, maintaining a sensible work-life balance, and producing outstanding results through engaged employees. Together, we can help make the world more resilient. About the Role As a Reinsurance Claims Specialist at Swiss Re, you'll manage a portfolio of asbestos, pollution, and health hazard (APH) reinsurance claims across various lines of business for both active and runoff portfolios. This role offers a unique opportunity to collaborate across functions, develop broad knowledge about the insurance and reinsurance industry, and help steer the business through data-driven insights and strong client partnerships. Key activities of the role include: * Steer a diverse portfolio of multi-line reinsurance claims, ensuring strategic performance through data analysis and industry insight. * Analyze contractual obligations, establish and monitor reserves, and approve payments within authority to ensure timely, effective resolution. * Apply advanced data analytics and reporting tools to manage the portfolio and identify emerging trends. * Collaborate with Underwriting, Actuarial, and other teams to provide portfolio insights that inform business strategy and decision-making. * Formulate, develop, and implement account management, including building and supporting client relationships. * Participate in client meetings and audits to review claims, assess claims-handling practices, and support collaborative problem-solving. * Deliver high-quality claims and client service, sharing industry knowledge and contributing to continuous improvement initiatives. * Support internal stakeholders with research on claim topics, loss development, and contract wording issues, while ensuring compliance with governance, legal, and reporting requirements. About the Team You'll join a team of APH claims professionals known for deep technical expertise, collaborative spirit, and innovative problem-solving. We work closely with clients and internal partners to deliver exceptional claims management, identify potential exposures, and provide meaningful insights that shape our business. If you're curious, analytical, and motivated by teamwork and impact, this is the place for you. About You You excel in a dynamic environment, adept at juggling multiple priorities while maintaining professionalism. With strong interpersonal skills, you're confident communicating with clients, legal counsel, and senior management, and you bring curiosity and strategic thinking to every challenge. Additional requirements include: * Bachelor's degree required. * At least 2-5 years of experience in claims, underwriting, insurance, reinsurance, or insurance-related legal work, including handling latent direct insurance claims. * General understanding of and/or exposure to other insurance disciplines i.e., contract wording, accounting, underwriting. * Ability and passion to manage a complex portfolio with critical analysis and innovative strategic thought. * Confirmed ability to meet deliverables, implement plans, and conduct analysis. * Excellent writing skills and proficiency in MS Office tools, claims systems and the ability and willingness to learn new systems. * Excellent organizational and data analytics skills with openness for continued growth. * Ability and willingness to learn new claims handling systems. * Some business travel required. The estimated base salary range for this position in Kansas City, MO is $84,000 to $140,000; for Armonk, NY is $90,000 to $150,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation. About Swiss Re Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world. Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability. If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience. Keywords: Reference Code: 136396 Nearest Major Market: White Plains Nearest Secondary Market: New York City Job Segment: Claims, Compliance, Data Analyst, Accounting, Actuarial, Insurance, Legal, Data, Finance
    $90k-150k yearly 30d ago
  • Claims Specialist

    Berkley 4.3company rating

    Claim processor job in Parsippany-Troy Hills, NJ

    Company Details Berkley Luxury Group is an operating unit of W.R. Berkley Corporation, one of America's largest commercial lines writers in the United states. At Berkley Luxury Group we offer tailored, all-inclusive insurance solutions for luxury condo, co-op, rental properties and fine dining restaurants. Berkley Luxury Group has been a mainstay in the commercial real estate and hospitality business since 1986. We specialize in luxury condominiums, cooperatives, and apartments in the habitational space, Class A Office buildings and fine dining restaurants in the hospitality space. BLG maintains a standard of prompt and fair settlement of claims, and endeavors to treat insureds and brokers in a partnership-like manner. BLG has developed a strategic plan to grow their success by expanding their footprint geographically and adding complementary products. At BLG there is a shared vision to be the best option for its customers. We aim to provide comprehensive insurance solutions, use enhanced data and technology to make more informed decisions and rely on a field-based underwriting, claims and loss control model to be closer to our customers and brokers. Our goal is to provide superior services and products to these unique businesses. At Berkley Luxury Group, our employees are our most important asset. We recognize that if we properly support and develop our employees, they will become our primary sustainable competitive advantage and the key to achieving success. As such, we have created a high performing culture incorporating our values into work practices, policies, and processes to foster, reinforce and sustain an environment where employees share a strong sense of purpose, commitment, and motivation to meet and exceed their goals. As a Berkley company, we enjoy operational flexibility that allows us to deliver quality coverage solutions. W. R. Berkley Corporation, and all member insurance companies, are rated A+ (Superior) by A.M. Best Company and carry Standard & Poor's Financial Rating of A+ (Strong). The company is an equal opportunity employer. Responsibilities Berkley Luxury is seeking a Senior Claims Specialist to join our team! This role is located is our new Parsippany NJ office. As a Claim Specialist, you will manage a wide range of commercial lines casualty claims, focusing on developing and implementing effective resolution strategies while delivering exceptional customer service. In this role, you will ensure high-quality claims handling through investigation, accurate analysis of coverage and liability, precise damage assessment, and resolution of claims, including those in litigation. As a key member of the casualty team, you will also help foster a culture of accountability, collaboration, continuous learning, and proactive performance improvement-contributing to both departmental excellence and the overall success of the company. Conduct thorough investigation and expert analysis of claims facts to determine coverage, liability, and applies appropriate legal concepts to evaluate damages and recommend appropriate course of action. Analyze and interpret policy language and case law in conjunction with specific loss facts to reach appropriate coverage decisions and write appropriate coverage correspondence in compliance with state statutes and regulations. Demonstrate a strong sense of urgency in promptly conducting comprehensive claims investigations to assess damages and liability, establish accurate reserves, and actively pursue timely and appropriate resolutions. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposures, risk transfer, reserve adjustments, coverage issues, and claim resolution strategies. Resolve claims through negotiation, mediation, and arbitration with minimal assistance. Address inquiries from brokers and policyholders and provide superior customer service. Attend and participate in industry related conferences, seminars, and webinars and demonstrating a personal commitment to professional development. Ensure claims handling compliance and alignment with insurance regulations and Company policies. May participate in projects and other corporate initiatives such as audits, task forces, focus groups, etc. Other duties as required. Qualifications Education Bachelor's degree or equivalent experience JD degree a plus Experience 5-7 years of experience handling commercial general liability claims. Experience managing litigated claims and working with defense counsel. Proven track record of effective claims resolution and negotiation. Technical Skills Strong knowledge of claims investigation techniques, liability assessment, and damage evaluation. Demonstrated expertise in legal processes and litigation management. Ability to interpret and apply policy language accurately. Analytical & Decision-Making Demonstrated critical thinking and sound judgment in analyzing claims. Advanced analytical abilities to evaluate liability, quantify damages, and determine exposure. Proven capacity to make prompt, well-reasoned, and evidence-based decisions. Communication & Interpersonal Excellent written, verbal, and presentation communication skills. Effective communicator with diverse stakeholders, including policyholders, claimants, attorneys, and internal teams. Strong negotiation skills Organizational & Time Management Strong organizational skills with attention to detail. Effectively manages priorities and meets deadlines in a fast- paced environment. Team & Culture Fit Takes ownership, shows initiative, and approaches problem-solving with a proactive mindset. Collaborative team player dedicated to achieving shared goals. Committed to continuous improvement and ongoing professional development. Supports and upholds the company's commitment to equal employment opportunity. Additional Company Details The company is an equal opportunity employer. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role includes: Base Salary Range: $83,000 - $156,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Eligible to participate in the annual discretionary bonus program. Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. Sponsorship Details Sponsorship not Offered for this Role
    $83k-156k yearly Auto-Apply 60d+ ago
  • Complex Liability Claims Specialist - Commercial General Liability

    Utica National Insurance Group 4.8company rating

    Claim processor job in New Hartford, NY

    The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an "A" rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in multiple jurisdictions. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required. Key responsibilities * Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in multiple jurisdictions. * Manage all claims in accordance with Utica National's established claim procedures. * Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level. * Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy. * Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims. * Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials. * Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle. * Achieve the service standard of "excellent" during all phases of claims handling. * Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction. * Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling. What you need * Four year degree or equivalent experience preferred. * Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims. * Proven experience negotiating claims and active participation in alternative dispute resolution practices. * Experience with general liability, additional insured considerations and complex coverage determinations. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary range: $103,300 - $140,000 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: * Medical and Prescription Drug Benefit * Dental Benefit * Vision Benefit * Life Insurance and Disability Benefits * 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) * Health Savings Account (HSA) * Flexible Spending Accounts * Tuition Assistance, Training, and Professional Designations * Company-Paid Family Leave * Adoption/Surrogacy Assistance Benefit * Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance * Student Loan Refinancing Services * Care.com Membership with Back-up Care, Senior Solutions * Business Travel Accident Insurance * Matching Gifts program * Paid Volunteer Day * Employee Referral Award Program * Wellness programs Additional Information: This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1
    $103.3k-140k yearly 29d ago
  • Associate Claims Examiner

    Markel Corporation 4.8company rating

    Claim processor job in Summit, NJ

    What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Associate Claims Examiner will be responsible for the resolution of claims with the Prompt Resolution Team (PRT) of lower complexity and exposure. This position will have decision-making authority in the amount of $25,000 and work under the general direction of their manager. The ACE position supports all product lines in Casualty with particular emphasis on Binding and Commercial Wholesale Primary and Small Commercial Programs. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims. * Conducts, coordinates and directs investigation into loss facts and extent of damages. * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. * Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. * Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications * Must have or be eligible to receive claims adjuster license. * Successful completion of basic insurance courses or achievement of industry designations. * Ability to be trained in insurance adjusting up to two years of claims experience. * 2-4 years of experience in general liability, construction defect, or related liability lines preferred. * Bachelor's degree preferred * Excellent written and oral communication skills. * Strong organizational and time management skills. #LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $25 - $38.25 with a 10% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.
    $49k-72k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim processor job in Melville, NY

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

    Cox Enterprises 4.4company rating

    Claim processor job in Manheim, PA

    Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description This position facilitates the resolution of customer claims and concerns (includes all physical and digital/online transactions) after a sale and is responsible for the timely and successful arbitration of vehicles between buyer and seller in accordance with auction and NAAA policies. The role will work to gain familiarity with fundamental arbitration concepts, procedures, standards, policies and systems. This position requires organization and management of sale day activities including post sale inspections and sale day arbitrations. Job Responsibilities: Basic Functional Duties * With guidance, performs basic Arbitrator duties, including: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluates claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communications for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. Knowledge & Subject Matter Milestones * Demonstrates an understanding of investigating claims and negotiating and influencing others while maintaining a positive client experience. * Gains familiarity and understanding of Arbitration concepts and procedures. * Gains foundational understanding of auction-specific operational and administrative processes. * Learns and adheres to National Auto Auction Association (NAAA) arbitration standards, Manheim Marketplace Policies, and relevant legal requirements. Client Interaction/Communication Responsibilities * Advises clients of the arbitration claim process, company policies, any auction- or account-specific guidelines, and NAAA guidelines. * Facilitates both written and verbal communications between buyers, sellers, and various auction team members and third parties to actively gather information necessary to guide parties toward agreement and resolution, while maintaining an awareness of goals and objectives. * Provides relevant information such as claim status to clients. Other Duties * Demonstrates safety commitment by following all safety and health procedures and modeling the appropriate behaviors. * Participates in support of all safety activities aligned with Safety Excellence. * Performs other duties as assigned. Qualifications and Experience * Education * High School Diploma or equivalent required. * Bachelor's degree preferred. * Experience * Previous experience in claims management and/or problem and conflict resolution preferred. Claim adjuster experience is a plus. * 1-2 years of experience in areas of responsibility. * 1+ years of automotive, mechanical, and/or body shop experience preferred. * Skills and Abilities * Active Listening * Accuracy and Attention to Detail * Resilience/Adaptability * Demonstrates Empathy * Verbal and Written Communication * Decision Making * Customer Focus * Time Management * Conflict Resolution * Builds Positive Relationships YDGCOX Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
    $16.6-24.9 hourly Auto-Apply 11d ago
  • Epic Medical Analyst

    Together We Talent 3.8company rating

    Claim processor job in New York

    Jamaica, NY (Onsite) | Direct Hire | $121,000-$150,000 | Hospital & Health Care | Information Technology Support the implementation, optimization, and ongoing maintenance of Epic EHR modules to improve clinical workflows and patient care across a healthcare organization. Position Overview We are seeking an experienced Epic Medical Analyst to support the build, maintenance, and optimization of Epic Electronic Health Record (EHR) modules. This role partners closely with clinical, administrative, and IT teams to ensure Epic applications are configured effectively, aligned to operational needs, and fully supported post -implementation. The ideal candidate brings hands -on Epic experience, strong analytical skills, and the ability to translate clinical and business requirements into scalable Epic solutions. This is a fully onsite role based in Jamaica, NY. Key Responsibilities Epic System Configuration & Support Configure, maintain, and optimize Epic modules to support clinical and operational workflows. Troubleshoot system issues and ensure optimal application performance. Support system upgrades, patches, and enhancements through testing and validation. Workflow Analysis & Optimization Analyze current clinical and administrative workflows to identify improvement opportunities. Partner with stakeholders to design and implement Epic -based solutions that enhance efficiency and patient care. Translate business and clinical requirements into system configurations and functional designs. User Training & Support Provide training and ongoing support to end users on Epic functionality and best practices. Respond to user inquiries and resolve application -related issues. Develop and maintain training materials, user guides, and documentation. Reporting, Testing & Quality Assurance Utilize Epic reporting tools to extract and analyze data for operational and quality improvement initiatives. Conduct system testing and quality assurance to ensure changes meet requirements and function as intended. Participate in process improvement initiatives to enhance system accuracy, efficiency, and usability. Collaboration & Communication Work closely with clinical, IT, and administrative teams to support implementation and ongoing optimization efforts. Ensure system requirements are clearly understood and effectively delivered. Requirements Required Qualifications Bachelor's degree in Computer Science, Healthcare Information Technology, Health Information Management, or a related field. Minimum of one year of hands -on experience building, maintaining, or supporting Epic modules. Strong understanding of healthcare operations and clinical workflows. Excellent communication, organizational, and problem -solving skills. Preferred Qualifications Epic Certification in relevant modules such as EpicCare Ambulatory, EpicCare Inpatient, or Clinical Documentation. Two or more years of Epic application experience. Preferred Tools & Skills Epic EHR applications and reporting tools Microsoft Office Suite Knowledge of HIPAA and healthcare data privacy regulations Strong analytical and troubleshooting skills Attributes & Mindset Detail -oriented with strong documentation skills. Able to manage multiple priorities in a complex healthcare environment. Comfortable collaborating with clinical, technical, and administrative stakeholders. Comfortable collaborating with clinical, technical, and administrative stakeholders.
    $39k-48k yearly est. 4d ago
  • Epic Medical Analyst

    Your It Recruiter

    Claim processor job in New York

    Your IT Recruiter is looking for an Epic Medical Analyst for our client. An Epic Medical Analyst, also referred to as an Epic Analyst or Epic Clinical Analyst, is an IT professional in healthcare specializing in the Epic Electronic Health Record (EHR) system. Their primary responsibilities revolve around implementing, optimizing, maintaining, and supporting Epic modules to enhance patient care and streamline workflows within healthcare organizations. Here's a breakdown of the key responsibilities, qualifications, and skills typically found in an Epic Medical Analyst job description: Key responsibilities and duties System configuration and maintenance Business Analysis and Workflow Improvement: Analyzing current workflows, identifying areas for improvement, and implementing Epic solutions to enhance efficiency. Collaborating with clinical and administrative teams to understand their needs and develop solutions within Epic. User Training and Support: Providing training to users on how to effectively utilize Epic, offering ongoing support, and addressing user inquiries. Documentation and Reporting: Creating and maintaining documentation, training materials, and user guides. Utilizing Epic's reporting tools to extract and analyze data for decision -making and quality improvement purposes. Collaboration and Communication: Working closely with clinical, IT, and administrative teams to ensure system requirements are met and to facilitate smooth implementation and ongoing support. Testing and Quality Assurance: Conducting system testing, quality assurance, and ensuring system updates and patches are properly implemented. Process Improvement: Participating in process improvement projects to enhance efficiency and accuracy. Requirements Required qualifications Education: Typically requires a Bachelor's degree in a related field such as Computer Science, Healthcare Information Technology, or Health Information Management. A Master's degree may be preferred. Experience: Minimum of one year of experience with the build and/or maintenance of Epic modules is often required. Some positions may prefer two or more years of relevant experience. Certification: Epic Certification in relevant modules (e.g., EpicCare Ambulatory, EpicCare Inpatient, Clinical Documentation) is usually a requirement or highly preferred, according to Medisys Health Network, Hospital for Special Surgery, and ZipRecruiter. Necessary skills Key skills for an Epic Medical Analyst include strong communication, organization, attention to detail, and the ability to multitask and work independently. Technical expertise in healthcare, IT and troubleshooting is essential. Analytical and problem -solving abilities are important, as is the capacity to collaborate with diverse teams. A solid understanding of healthcare operations, clinical workflows, and proficiency in Microsoft Office Suite are often required. Knowledge of HIPAA and other healthcare data privacy regulations is necessary. Staying current with industry trends and advancements in Epic applications is also valued. Overall, an Epic Medical Analyst is crucial for ensuring the Epic EHR system effectively supports a healthcare organization's operations, leading to improved patient care and efficiency. BenefitsContract Role
    $35k-55k yearly est. 6d ago
  • Claims Specialist 3- Staffing

    Circet USA

    Claim processor job in Englewood Cliffs, NJ

    Job Description Circet USA is the leading provider of Network Services in North America, and we're looking for talented professionals to join our team. We specialize in engineering and construction services delivering comprehensive solutions across Inside Plant, Outside Plant, and Wireless networks to meet the evolving infrastructure needs of our customers. With nearly 50 years of industry experience, we work with major telecom service providers, MSOs, cloud service providers, and utilities. At Circet USA, you'll have the opportunity to make an impact by helping to create customized solutions that address our clients' unique challenges. If you're passionate about innovation and thrive in a dynamic environment, we'd love to hear from you. Circet USA's benefits package includes the following: Medical, Dental, and Vision insurance Digital Health & Wellness Support Critical Illness, Accident, & Hospital Insurance Short-term & Long-term disability Group term & Voluntary life insurance Flexible Spending and Health Savings Accounts Paid Time Off & 401K Company Discount Website Responsibilities We are seeking a highly skilled and experienced Claims Specialist 3 to fulfill a staff augmentation role with Circet USA's customer. The primary objective of the Claims Specialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management. The goal of the Claims Specialist is to support the Product Safety Team by handling Claims with professionalism, care and urgency, making sure claims are reported and being handled in a timely manner. To achieve the highest performance, the person in this position is expected to maintain effective and timely communication with key customers, claims adjusters, stakeholders and leaders within the department, team, and cross-department where applicable. ESSENTIAL DUTIES & RESPONSIBILITIES include the following. Other duties may be assigned: Collaborate with team members in the Product Safety department, PL Insurance Carrier, outside law firm and 3rd Party administrators. Generate daily/weekly/monthly reports, with analysis and recommendations Manage 4-7 ongoing and ad-hoc projects that may include KPIs and Metrics Ensure that all projects have required documentation as they move through the project tollgates Communicate to Product Liability leadership on project status and escalation/decision points Works cross functionally with HQ teams in Korea (occasional evening conference call) and SEA operations to manage all possible risks. Pending Claim Management, KPI & TAT Management - Claim registration to closure Product Verification Liability Assessment by reviewing diagnosis results Reporting on high-profile claims to the leadership Qualifications Bachelor's Degree (or equivalent experience) 3-5 years of hands-on claims management & customer care experience Expertise in MS, Excel, and PPT Proven capability to analyze data and develop a course of action Proven ability to prioritize and manage multiple projects, meet deadlines and drive to resolution Process, procedure, strategic planning and project development experience Experience working with and influencing cross-functional teams. Experience working within the insurance and/or home appliance industry a plus Experience with product development or testing a plus Experience working in a complex and wide organization and department Claims Adjuster License a plus Takes project ownership and possess leadership qualities with an entrepreneurial approach Circet USA is an Equal Opportunity Employer - Veteran/Disabled. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by law.
    $44k-79k yearly est. 21d ago
  • Third Party Claims Specialist

    DCS Asset Maintenance 4.5company rating

    Claim processor job in Hazleton, PA

    DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family! To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about! Job Description Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA. Duties include - but not limited to: Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies. Coordinate with project offices to obtain accurate information, records and photos needed to create invoices. Creation and submission of accurate invoices to insurance carriers and vehicle owners. Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days. Accurately updating claim records for any contact or actions taken on claim invoice. Create and run reports as necessary for claim tracking and follow-up Support to project offices as necessary - including police report investigation and contacting insurance companies. Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage. Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager. Other duties as assigned. Qualifications EDUCATION: High School Diploma is required. EXPERIENCE: Prior experience in insurance claims preferred - 2 years or more relative experience Excellent computer skills - Proficient in Microsoft Office Word & Excel Customer service focused Detail oriented Self-starter - ability to work independently. Ability to interact productively and positively in a team environment. Ability to communicate effectively and professionally in both verbal and written form. PHYSICAL REQUIREMENTS: Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone. Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices. Able to see and read on computer screens and paper, close vision. Ability to lift and carry items up to 10 pounds. Ability to sit at a desk comfortably while working on a computer for extended periods of time. Additional Information Benefit Highlights: Challenging and rewarding work environment Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) Generous Paid Time Off Career Development Pay rate: $20.00-23.00/hour depending on experience Come be a part of the DeAngelo family, today! DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
    $20-23 hourly 7d ago
  • Third Party Claims Specialist

    Deangelo Brothers, LLC 4.1company rating

    Claim processor job in Hazleton, PA

    DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family! To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about! Job Description Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA. Duties include - but not limited to: Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies. Coordinate with project offices to obtain accurate information, records and photos needed to create invoices. Creation and submission of accurate invoices to insurance carriers and vehicle owners. Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days. Accurately updating claim records for any contact or actions taken on claim invoice. Create and run reports as necessary for claim tracking and follow-up Support to project offices as necessary - including police report investigation and contacting insurance companies. Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage. Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager. Other duties as assigned. Qualifications EDUCATION: High School Diploma is required. EXPERIENCE: Prior experience in insurance claims preferred - 2 years or more relative experience Excellent computer skills - Proficient in Microsoft Office Word & Excel Customer service focused Detail oriented Self-starter - ability to work independently. Ability to interact productively and positively in a team environment. Ability to communicate effectively and professionally in both verbal and written form. PHYSICAL REQUIREMENTS: Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone. Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices. Able to see and read on computer screens and paper, close vision. Ability to lift and carry items up to 10 pounds. Ability to sit at a desk comfortably while working on a computer for extended periods of time. Additional Information Benefit Highlights: Challenging and rewarding work environment Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) Generous Paid Time Off Career Development Pay rate: $20.00-23.00/hour depending on experience Come be a part of the DeAngelo family, today! DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
    $20-23 hourly 1d ago
  • Claims Processing Specialist

    Blackburn's Physicians Pharmacy 3.5company rating

    Claim processor job in Tarentum, PA

    Job Opening: Claims Processing Specialist at Blackburn's Are you a detail-oriented professional with a passion for the healthcare industry? Blackburn's is looking for a Claims Processing Specialist to join our Corporate Claims department and perform third-party medical billing functions. If you thrive in a fast-paced environment and possess excellent organizational and communication skills, this could be the perfect opportunity for you! What You'll Do: Manage and verify third-party medical claims for accuracy and compliance. Collaborate with cross-functional teams to resolve billing discrepancies and insurance denials. Process claims efficiently while adhering to strict filing deadlines. Contribute to the improvement of billing processes to reduce denials and increase efficiency. Utilize your strong communication skills to work with internal teams and external clients. Why Join Us? At Blackburn's, we're committed to creating a positive impact in the healthcare industry by delivering quality products and services. As part of our team, you'll have access to in-house training, opportunities for career growth, and a collaborative work environment. We offer competitive pay, benefits, and the chance to be part of a company that values its employees. Work Hours: 8:00 a.m. - 4:30 p.m. or 8:30 a.m. - 5:00 p.m. If you have a passion for medical billing and enjoy working in a dynamic, fast-paced environment, we'd love to hear from you! Apply today and join us in making a difference at Blackburn's! Qualifications What We're Looking For: Prior experience in healthcare-related industries, preferably with third-party medical billing. Strong attention to detail, time management, and the ability to juggle multiple tasks. Excellent interpersonal skills, with the ability to work both independently and as part of a team. Proficiency in Microsoft Office, with knowledge of Word and Excel. Ability to work independently, prioritize workload, and adapt to changing environments.
    $25k-32k yearly est. 9d ago
  • Litigation Claims Specialist

    Questor Consultants, Inc.

    Claim processor job in Deptford, NJ

    Job DescriptionRisk Intermediary located in New Jersey seeks a VP of Claims for a Municipal Insurance fund. Claims handled are Workers Comp, Property and Liability and Professional Liability. Fund has 28 members submitting New Jersey based Public Entity based claims. This position will lead operational and administrative claims functions including reserving. Will also manage TPA relationships and direct TPA's Workers Comp activities. Will also manage staff Liability Litigation Managers and lead claims reporting. Require JD with 20 years experience in an Insurance Claims Department, TPA or Risk Management Department. Knowledge of New Jersey Civil Tort and Workers Comp claims systems. Advanced skills in Coverage Analysis, Litigation Management and Negotiation. Auto Liability, General Liability and Employer Liability claims. Knowledge needed in MS Office Products (Word, Excel and Powerpoint). Will work remote but must be within driving distance of office. Will manage 9-12 people. Minimal travel. Salary $150-200k no bonus opportunity.
    $45k-80k yearly est. 23d ago

Learn more about claim processor jobs

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

The average claim processor in Scranton, PA earns between $21,000 and $68,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Scranton, PA

$38,000
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