Davies Claims North America seeks an experienced Claims Representative to manage claims related to MTA operations, including minor property damage and complex bodily injury. Reporting to the MTA Claims Supervisor, this role involves investigation, litigation management, and reserve evaluation for claims exceeding $25,000.
Key Responsibilities:
Handle a caseload of 150+ files, some with multiple claimants
Investigate claims, manage litigation, and maintain detailed documentation
Evaluate reserves and issue timely reports
Uphold company values: Dynamic, Innovative, Connected, Collaborative
Perform additional duties as assigned
Requirements:
High school diploma or equivalent
Minimum 3 years of experience in auto property damage, bodily injury, and general liability claims
Proficiency in Microsoft Office
Familiarity with Medicare reporting requirements (Section 111)
Benefits:
Medical, dental, and vision coverage
401(k) with employer match
Paid holidays and time off
Life, short-term, and long-term disability insurance
$37k-57k yearly est. 4d ago
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Claims Examiner
Harris 4.4
Claim processor job in Washington, DC
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
ClaimsProcessor - Entry Level
Duration : 5 Months
Total Hours/week : 40.00
1
st
Shift
Client: Medical Device Company
Job Category: Customer Service
Level of Experience: Entry Level
Employment Type: Contract on W2 (Need US Citizens or GC Holders Only)
Work days/hours: M - F 8am - 5pm
Job Description:
The primary responsibility of this position is the investigation, analysis, resolution, trending and corrective action of all claims/complaints.
Specific responsibilities include maintaining claim/complaint files and supporting the resolution of claim/complaint CAPAs to closure and verification of CAPA effectiveness.
Bachelor's degree required.
Minimum of 2 years of experience in complaint investigation.
Strong communications and problem solving skills.
Ability to work independently.
Competent using office software including Database management, MS Word, Excel, Internet Explorer, PowerPoint, and Outlook.
Experience with SAP is required.
$39k-64k yearly est. 60d+ ago
Claims Examiner
Healthcare Support Staffing
Claim processor job in Annapolis, MD
Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you!
Essential Functions:
Reviews providers' disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures.
Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness
Perform any projects delegated by claims supervisor
Qualifications
Minimum Education/ Licensures/Qualifications
High School Diploma or GED
1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting
Healthcare Background
Understanding of Medical Terminology
Additional Information
Shift: M-F 8am-5pm
RTH or Temp-To-Perm (Any transition heavily depends on performance)
Pay Rate: Up to 20/hour
$37k-66k yearly est. 1d ago
Stop Loss & Health Claim Analyst
Sun Life Financial 4.6
Claim processor job in Baltimore, MD
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Job Description:
The Opportunity:
This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim.
The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources.
How you will contribute:
* Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
* The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions
* Maintain claim block and meet departmental production and quality metrics
* An awareness of industry claim practices
* Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records
* Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc.
* Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process
* Establish cooperative and productive relationships with professional resources
What you will bring with you:
* Bachelor's degree preferred
* A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing
* Demonstrated ability to work as part of a cohesive team
* Strong written and verbal communication skills
* Knowledge of Stop Loss Claims and Stop Loss industry preferred
* Demonstrated success in negotiation, persuasion, and solutions-based underwriting
* Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism
* Overall knowledge of health care industry
* Proficiency using the Microsoft Office suite of products
* Ability to travel
Salary Range: $54,900 - $82,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Category:
Claims - Life & Disability
Posting End Date:
30/01/2026
$54.9k-82.4k yearly Auto-Apply 19d ago
Subrogation Claims Specialist
Maryland Automobile Insurance Fund 4.1
Claim processor job in Baltimore, MD
Maryland Auto Insurance is a Property & Casualty Insurance carrier and independent agency of the State of Maryland. We're located in the Locust Point neighborhood of Baltimore, featuring a variety of restaurant and shopping options in walking distance from the office. This position is ideal for candidates who desire flexible work schedules. The incumbent will be required to come into the office a minimum of two days per month. We offer an excellent benefit package including comprehensive health and dental coverage, pension plan, 401(k) plan and incentive program tied to strategic corporate and departmental goals. Generous leave package, tuition reimbursement and free onsite parking available. This role is open to applicants residing in Maryland, Delaware, Pennsylvania, or New Jersey.
Position Summary
This position will be responsible for recovering monies due to Maryland Automobile Insurance from responsible parties, including uninsured motorists and insurance companies. The Subrogation Specialist will manage a steady case load of Subrogation files. The Subrogation Specialist may manage arbitration and be responsible for recovery of consumer subrogation claims.
Essential Functions:
Negotiate payment in full, settlement in full, or a payment plan
Attend hearings, mediations, settlement conferences, pre-trial hearings and fraud trials.
Pursue applicant arbitration, defend respondent arbitration and counter claims.
Competencies:
Strong written and verbal negotiation skills required.
Experienced, professional and creative writing skills and the ability to effectively communicate and persuade by printed word.
Must demonstrate the ability to write a professional contention.
Strong negotiation skills
Ability to work independently and professionally.
Professional demeanor and dependability.
Accuracy and attention to detail.
Critical thinker
Exercise considerable independent judgment
Strong organizational skills and the ability to prioritize and multi-task
PC skills required
Basic math skills
Ability to be receptive and responsive to change and to embrace continuous improvement.
Qualifications
Education & Experience:
High School Diploma or GED and 8 years of experience in automobile claims, automobile appraisal, law enforcement, or work involving conducting investigations or equivalent combination of education & experience. Subrogation and/or Arbitration experience preferred.
Maryland Auto Insurance is a drug-free workplace and an equal opportunity employer, committed to diversity in the workplace. We do not discriminate on the basis of race, color, religion, age, sex, marital status, national origin, physical or mental disability, familial status, genetic information, gender identity or expression, sexual orientation, or any other characteristic protected by State or federal law. Applicants who need an ADA accommodation for an interview should request the accommodation when notified of a request to be interviewed. Applicants must be United States citizens or eligible to work in the United States.
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$67,000.00 - $110,600.00
**Target Openings**
1
**What Is the Opportunity?**
LOCATION REQUIREMENT: This field position services Insureds/Agents in the Maryland area. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
*You will be issued a company vehicle for this position.*
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.
**What Will You Do?**
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May provides mentoring and coaching to less experienced claim professionals.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
+ This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree.
+ General knowledge of estimating system Xactimate.
+ Two or more years of previous outside property claim handling experience.
+ Interpersonal and customer service skills - Advanced.
+ Organizational and time management skills- Advanced.
+ Ability to work independently - Intermediate.
+ Judgment, analytical and decision making skills - Intermediate.
+ Negotiation skills - Intermediate.
+ Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate.
+ Investigative skills - Intermediate.
+ Ability to analyze and determine coverage - Intermediate.
+ Analyze, and evaluate damages -Intermediate.
+ Resolve claims within settlement authority - Intermediate.
+ Valid passport.
**What is a Must Have?**
+ High School Diploma or GED.
+ One year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program.
+ Valid driver's license.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
$67k-110.6k yearly 23d ago
Claims Examiner
Harriscomputer
Claim processor job in Washington, DC
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
$29k-51k yearly est. Auto-Apply 42d ago
Claims Initiation Analyst
Collabera 4.5
Claim processor job in Cockeysville, MD
Established in 1991, Collabera is one of the fastest growing end-to-end information technology services and solutions companies globally. As a half a billion dollar IT company, Collabera's client-centric business model, commitment to service excellence and Global Delivery Model enables its global 2000 and leading mid-market clients to deliver successfully in an increasingly competitive marketplace.
With over 8200 IT professionals globally, Collabera provides value-added onsite, offsite and offshore technology services and solutions to premier corporations. Over the past few years, Collabera has been awarded numerous accolades and Industry recognitions including.
Collabera awarded Best Staffing Company to work for in 2012 by SIA. (hyperlink here)
Collabera listed in GS 100 - recognized for excellence and maturity
Collabera named among the Top 500 Diversity Owned Businesses
Collabera listed in GS 100 & ranked among top 10 service providers
Collabera was ranked:
32 in the Top 100 Large Businesses in the U.S
18 in Top 500 Diversity Owned Businesses in the U.S
3 in the Top 100 Diversity Owned Businesses in New Jersey
3 in the Top 100 Privately-held Businesses in New Jersey
66th on FinTech 100
35th among top private companies in New Jersey
***********************************************
Collabera recognizes true potential of human capital and provides people the right opportunities for growth and professional excellence. Collabera offers a full range of benefits to its employees including paid vacations, holidays, personal days, Medical, Dental and Vision insurance, 401K retirement savings plan, Life Insurance, Disability Insurance.
Job Description
Claims Initiation Analyst II: Receives incoming calls and assists customers with questions or issues regarding potential fraudulent activity on a deposit account (checking, savings) . Takes appropriate action based on an evaluation of the customer's needs which may include, filing a new claim(s), updating and follow-up on existing claim(s), and/or reviewing appeals on denied claims. Takes personal ownership to ensure that customer requests are processed quickly and efficiently, while maintaining compliance with industry regulations and bank procedures. Responsibilities include but are not limited to: initiating claims using multiple systems and tools, providing first call resolution on inquiries, and may assist the customer in resolving disputes directly with the merchant. May debit or credit customer's accounts, as appropriate. May research and resolve other general customer account inquiries as appropriate and/or escalate issues on the customer's behalf while providing world class customer service. Understand and adhere to established service level agreements and set appropriate expectation with the clients and customers regarding the claims process.
Ideal candidate will have credit card knowledge in a customer service contact center.
Qualifications
Critical Skills:
* Claims experience (in financial industry, preferrably but not required)
* Customer service experience (in a call center environment, preferred but not required)
* credit card experience (preferred but not required)
Additional Information
Should you have any questions, please feel free to call me on ************.
Email your resume to: ********************************
$67k-92k yearly est. Easy Apply 1d ago
Claims Innovation - Senior Analyst - Casualty or Commercial PD
Geico 4.1
Claim processor job in Chevy Chase, MD
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
About GEICO
The Government Employees Insurance Company (GEICO) is a private American auto insurance company with headquarters in Chevy Chase, Maryland. GEICO is a wholly owned subsidiary of Berkshire Hathaway and is the third largest auto insurer in the United States. In 2023, GEICO earned premiums worth over $40 billion U.S. dollars.
GEICO is going through a massive digital transformation to re-platform the Insurance industry, removing friction across Customers, Partners, Marketplace, Segments, Channels, and Experiences as we grow our reach and market share.
About The Role
GEICO is hiring a
Innovation Analyst
to join their Claims Innovation team. As an Innovation Analyst, you will support GEICO's Claims Innovation team in identifying, analyzing, and implementing opportunities to improve processes and technology. This role partners with cross-functional teams to deliver innovative solutions that enhance efficiency, accuracy, and customer experience.
Responsibilities:
Evaluate and analyze existing claims processes, data, and performance metrics to identify areas of opportunity for efficiency, effectiveness, or accuracy
Gather and analyze data to provide insights into claims processes and performance metrics
Support the development of actionable strategies and assist in implementing process and technology enhancements.
Assist the Director, Claims Innovation in establishing priorities, goals, and objectives
Collaborate with Operations, Product, AI/ML, and Engineering teams to define and prioritize requirements.
Prepare reports and presentations summarizing findings, recommendations, and project progress.
Contribute to and/or lead pilot programs, POC's, or A/B testing and reporting on performance and progress
Participate in innovation workshops, ideation sessions, and design sprints.
Monitor project risks, benefits, and performance metrics; escalate issues as needed.
Stay informed on industry trends, emerging technologies, and best practices.
About You
Skills & experiences:
3+ years of experience in business process optimization, business analysis, consulting, innovation, or process engineering.
Leadership experience in P&C insurance claims
Bachelor's degree in Business, Finance, Economics, Statistics, or related field.
Knowledge of innovation methodologies, processes, and principles
Strong analytical skills and ability to interpret data for decision-making.
Effective communicator with strong collaboration skills.
Demonstrated ability to adapt and learn in a fast-paced environment.
Commitment to diversity, equity, and inclusion.
Leadership qualities:
Leads from the front and isn't shy about using their voice
Ability to lead and influence with empathy and humility
Ability to navigate and lead through complexity
Curiosity, critical thinking skills; a lifelong learner who sees situations through multiple lenses
Exceptional character and an ability to instill confidence and build trust. Someone who possesses high emotional intelligence, and is an attentive, empathetic listener
Location:
Remote, or available office
#LI-HB1
Annual Salary
$82,000.00 - $172,200.00
The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations.
At this time, GEICO will not sponsor a new applicant for employment authorization for this position.
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs.
We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
$82k-172.2k yearly Auto-Apply 16d ago
Property Claims Specialist
Erie Insurance 4.6
Claim processor job in Silver Spring, MD
Division or Field Office: Claims II Division Property Damage Dept Work from: Home in Maryland Salary Range: $79,191.00 - $126,500.00 * salary range is for this level and may vary based on actual level of role hired for * This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment.
At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia.
Benefits That Go Beyond The Basics
We strive to be Above all in Service to our customers-and to our employees. That's why Erie Insurance offers you an exceptional benefits package, including:
* Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work.
* Low contributions to medical and prescription premiums. We currently pay up to 97% of employees' monthly premium costs.
* Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service.
* 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension.
* Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave.
* Career development. Including a tuition reimbursement program for higher education and industry designations.
Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year.
Position Summary
Exercises independent discretion or judgment in the handling of assigned property claims. Serves as a consultant to claims adjusters in their handling of property losses.
* This is a remote, work from home position
* A company car will be provided
* The candidate will ideally live in and service the DC, Southern MD & Eastern Shore territory
Duties and Responsibilities
* Establishes immediate contact with Policyholders and claimants.
* Conducts extensive investigations into causes and origins of all major property claims. Interviews insureds, claimants and others as required. Inspects property damage, reviews information to prepare estimates, evaluates and makes recommendations regarding coverage of claims, determines liability and total value of claims and negotiates settlements. Sets and maintains adequate reserves.
* Exercises discretion and independent judgment in evaluating property damage in order to determine the extent of damage. Determines liability and total value of claim, develops estimate and obtains an agreed scope of work and cost of repair with contractor and/or Policyholder.
* Determines value as they apply to the coverage.
* Determines steps necessary to initiate investigation of a property loss. Uses outside experts and attorneys as required.
* Documents claim files and submits final report to file for closure.
* Assigns and supervises the handling of property losses by independent adjusters when necessary. Advises claims adjusters regarding handling of claims.
* Conducts related training of field office claims personnel in the branch and at the Home Office.
* Attends industry-related training programs to stay current on legal developments and ensure compliance with applicable laws and regulations impacting the operation of the department.
* Establishes and maintains relationships with local, state and regional organizations and agencies which are involved in related activities.
* Acts as coordinator of the Catastrophe Team activities at catastrophe site.
The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.
This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become clear.
Capabilities
* Values Diversity
* Self-Development
* Nimble Learning
* Collaborates
* Information Management Skills
* Customer Focus
* Cultivates Innovation
* Job-Specific Knowledge
* Instills Trust
* Optimizes Work Processes (IC)
* Ensures Accountability
* Decision Quality
Qualifications
Minimum Educational and Experience Requirements
* High School Diploma or GED and five years of claims handling experience (up to two years of equivalent may be substituted); or
* Bachelor's Degree and three years of claims handling experience, (up to two years of equivalent experience may be substituted.)
Additional Experience
* Working knowledge of Windows software required.
* The position requires the incumbent to serve on Catastrophe Team, which may include travel on short notice to other locations for periods in excess of two consecutive weeks.
* Position requires the incumbent to provide 24-hour availability for emergency claims service.
Designations and/or Licenses
* Successful completion of Introduction to Claims (AIC 30) and AIC 35 preferred.
* Appropriate license as required by state.
* Valid driver's license and good driving record required.
Physical Requirements
* Use of Personal Protective Equipment (PPE) is required for this role.
* Ability to move over 50 lbs using lifting aide equipment; Often (20-50%)
* Climbing/accessing heights; Moderate (30-40%)
* Driving; Frequent (50-80%)
* Lifting/Moving 0-20 lbs; Often (20-50%)
* Lifting/Moving 20-50 lbs; Often (20-50%)
* Manual Keying/Data Entry/inputting information/computer use; Often (20-50%)
* Pushing/Pulling/moving objects, equipment with wheels; Occasional (
$79.2k-126.5k yearly 2d ago
Claims Processor (remote) Iowa ONLY
Cognizant 4.6
Claim processor job in Washington, DC
**Claims Processing - Remote** for Iowa resident candidates Join our team as a Claims Processing Executive in the healthcare sector where you will utilize your expertise in MS Excel to efficiently manage and process commercial claims. This remote position offers the flexibility of working from home during day shifts allowing you to balance work and personal commitments effectively. Your contributions will directly impact the accuracy and efficiency of our claims processing enhancing customer satisfaction and operational excellence. _You will report to our office in Des Moines, Iowa for part of our training regimen._
**Key Responsibilities-**
+ _Claims Processing:_ Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies.
+ _Eligibility Verification:_ Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans.
+ _Adjudication:_ Approve, deny, or adjust claims based on payer guidelines and policy terms.
+ _Compliance:_ Maintain adherence to HIPAA regulations, CMS guidelines, and other US healthcare compliance standards.
+ _Documentation:_ Record claim activity, maintain audit trails, and prepare reports for management.
**Required Skills & Qualifications-**
+ High school diploma or equivalent REQUIRED
+ Strong knowledge of US healthcare insurance systems (Medicare, Medicaid, commercial payers).
+ 2-4 years of experience in US healthcare claims processing
+ Familiarity with claims management software and EDI transactions.
+ Excellent analytical, organizational, and communication skills.
+ Ability to interpret insurance policies and payer guidelines.
+ Detail-oriented with strong problem-solving abilities.
_Competencies-_
+ Regulatory Knowledge - Deep understanding of US healthcare laws and payer requirements.
+ Accuracy & Detail Orientation - Ensures claims are processed correctly and efficiently.
+ Problem-Solving - Resolves claim disputes and denials effectively. **Salary and Other Compensation:** Applications will be accepted until January 30, 2025.The hourly rate for this position is between $16.00 - 17.00 per hour, depending on experience and other qualifications of the successful candidate.This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans. **Benefits:** Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:- Medical/Dental/Vision/Life Insurance- Paid holidays plus Paid Time Off- 401(k) plan and contributions- Long-term/Short-term Disability- Paid Parental Leave- Employee Stock Purchase Plan _Disclaimer:_ The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
$16-17 hourly 16d ago
Experienced Outside Property Claim Representative - Washington, DC
Msccn
Claim processor job in Washington, DC
ATTENTION MILITARY AFFILIATED JOB SEEKERS
- Our organization works with partner companies to source qualified talent for their open roles. The following position is available to
Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers
. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Who Are We?
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$67,000.00 - $110,600.00
This position could be eligible for a sign on bonus.
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
What Will You Do?
Handles 1st party property claims of moderate severity and complexity as assigned.
Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
Broad scale use of innovative technologies.
Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Establishes timely and accurate claim and expense reserves.
Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
Writes denial letters, Reservation of Rights and other complex correspondence.
Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
Meets all quality standards and expectations in accordance with the Knowledge Guides.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
Manages file inventory to ensure timely resolution of cases.
Handles files in compliance with state regulations, where applicable.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
Identifies and refers claims with Major Case Unit exposure to the manager.
Performs administrative functions such as expense accounts, time off reporting, etc. as required.
Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
May provides mentoring and coaching to less experienced claim professionals.
May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
Must secure and maintain company credit card required.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
Perform other duties as assigned.
Additional Qualifications/Responsibilities
What Will Our Ideal Candidate Have?
Bachelor's Degree preferred.
General knowledge of estimating system Xactimate preferred.
Two or more years of previous outside property claim handling experience preferred.
Interpersonal and customer service skills - Advanced
Organizational and time management skills- Advanced
Ability to work independently - Intermediate
Judgment, analytical and decision making skills - Intermediate
Negotiation skills - Intermediate
Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
Investigative skills - Intermediate
Ability to analyze and determine coverage - Intermediate
Analyze, and evaluate damages -Intermediate
Resolve claims within settlement authority - Intermediate
Valid passport preferred.
What is a Must Have?
High School Diploma or GED required.
A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
Valid driver's license required.
$67k-110.6k yearly 19d ago
Senior Claims Analyst
Coast and Harbor Associates
Claim processor job in Washington, DC
Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with:
Furnishes reports with supporting information necessary to resolve disputes or defend against the claims,
Prepares and assembles appeal files,
Participates in meetings or negotiations with claimants,
Appears in legal proceedings,
Prepares cost estimates for use in claims negotiations,
Prepares risk assessments/analysis relative to claim exposures,
Prepares findings of fact and other documentation required by the CO.
Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models.
Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred.
Submit resumes and project list in MS Word or PDF format:
Please No Calls
$58k-101k yearly est. 60d+ ago
Catastrophe Data & Claims Analyst
Glatfelter Insurance Group 3.8
Claim processor job in York, PA
Job Description
Who We Are
For over 70 years, Glatfelter Insurance Group has believed in doing the right thing for our clients, agents, communities and associates. This founding principle has enabled Glatfelter to grow from the kitchen-table, one-man-operation as it began, to one of the largest managing general agencies in the U.S. with nearly 500 associates across the country, a distribution network of over 4,500 independent brokers and more than 30,000 clients. It is what drives us to innovate-the desire to deliver the best for our clients. Founded as The Glatfelter Agency, which is still in operation, the program basis of Glatfelter Insurance Group, Volunteer Firemen's Insurance Services (VFIS), was founded in 1969. Throughout the years, Glatfelter has expanded to include specialized program business inclusive of public entities, educational institutions, healthcare facilities, and religious organizations. Glatfelter provides their insureds with comprehensive insurance solutions including property, casualty, life insurance, and more. In 2018, Glatfelter joined American International Group (AIG) and is now part of the AIG family.
About the Position
This new role is central to Glatfelter's expansion of analytics capabilities, primarily in support of catastrophe management and claims predictions. The Analyst will work closely with Executive Leadership, Actuarial, Claims, and Underwriting in developing new tools to monitor and, ultimately, optimize the property portfolio's footprint relative to key catastrophe metrics (e.g. AAL, PML). In addition, they will create new claims reporting capabilities that will lead to better predictability of claims outcomes through incorporation of data mining/scraping and modeling. This position is required to be onsite at our York, PA or Berwyn, PA office.
Key Responsibilities
Monitoring and steering of CAT exposure through creation of accumulation tools, including mapping/visualizations.
Support individual deal evaluations through modeling and validation of US natural catastrophe (CAT) exposures/AAL
Training and support of the local AIG Programs & Glatfelter underwriting and actuarial teams on the fundamentals of CAT modeling, exposure monitoring, and CAT management
Contribute to portfolio management for AIG Programs & Glatfelter by devising a cost framework for optimizing AAL allocations
Validate analysis and resulting reinsurance cost allocations to AIG Programs & Glatfelter
Support post-CAT event impact analysis and provide timely exposure assessments Claims Analytics
Creation and refinement of key claims indicators that bring greater transparency and predictability to loss frequency and severity forecasts. Using various techniques (e.g. text mining, data scraping), build models that predict complex claims and large loss propensity.
Monitoring of critical coverage and high profile risks, such as abuse, PFAS, and excess liability
Investigate claims patterns and work with Actuarial to update loss development factors for use in pricing and reserving work
Work with IT to capture new metrics that contribute to claims predictability
Optimize claims resources through predictive measures by lines of business
What We're Looking For
Bachelor's degree in Mathematics, Economics, Business Administration, Computer Science, or related field.
Minimum of five (5) years of property and casualty commercial lines' experience in Analytics, Actuarial, Claims, and/or IT.
Excellent analytical skills and work with P&C insurance reporting and monitoring tools. Experience in building tools that support insurance functions (e.g. UW, Claims) is required.
Working knowledge of core P&C lines of business, as well as A&H
Working knowledge of Catastrophe modeling concepts (e.g. AAL, PML, accumulation) and industry models (e.g. RMS, AIR)
Strong organizational and communication skills.
Ability to make decisions within scope of authority.
Demonstrated advanced proficiency with Microsoft Excel & Power BI (or equivalent) products. Programming knowledge, such as SQL or Python, is preferred.
Why Choose Glatfelter?
Glatfelter is honored to have been named a Best Place to Work in PA since 2005. We are proud to offer a range of employee benefits and resources that help you protect what matters most - your health care, savings, financial protection and wellbeing. In addition to 17 paid holidays, (which includes a personal holiday and mental health and wellness day) we provide a variety of leaves for personal, health, family, and volunteer needs.
We believe in fostering our associates' development and offer a range of learning opportunities for associates to hone their professional skills to position themselves for the next steps of their careers. We have a tuition reimbursement program for eligible associates to enhance their education, skills, and knowledge in areas that relate to their current position or future positions to which they may transfer or progress.
Equal Opportunity Employer
It has been and will continue to be the policy of Glatfelter Insurance Group to be an Equal Opportunity Employer. We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories. At Glatfelter, we believe that diversity and inclusion are critical to our future and our mission - creating a foundation for a creative workplace that leads to innovation, growth, and profitability. Glatfelter is committed to working with and providing reasonable accommodations to job applicants and employees with physical or mental disabilities. If you believe you need a reasonable accommodation in order to search for a job opening or to complete any part of the application or hiring process, please contact Human Resources. Reasonable accommodations will be determined on a case-by-case basis.
Job Grade: 9
$64k-95k yearly est. 23d ago
Claims Analyst I
Healthcare Legal Solutions LLC
Claim processor job in Washington, DC
JOB TITLE: Claims Analyst
This position is responsible for assisting with following up on administrative appeals and documentation submitted to health insurers and governmental payers; working well with attorneys and paralegals; maintaining the workload.
DUTIES AND RESPONSIBILITIES:
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Determines action required to resolve the underpayment and initiate that action, including submitting appeals and reconsideration requests.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement
Quickly and efficiently prepares, reviews, and submits well-written claims correspondence and related documents to insurers
Is skilled, aggressive, cordial, and professional on the telephone to follow up on submitted appeals.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required :
BA/BS with a GPA of 3.0 or higher.
Interest in healthcare and healthcare law.
Able to navigate through various computer systems and applications to find information about insurance claims.
Ability to prioritize and multi-task.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Excellent organizational and time management skills.
High attention to detail.
Clear, concise, and logical writing style.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
External Working Relationships - Develops and maintains courteous and effective working relationships with clients, vendors and/or any other representatives of external organizations.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
$45k-80k yearly est. Auto-Apply 60d+ ago
Junior Travel Claims Analyst
Seneca Holdings
Claim processor job in Washington, DC
Great Waters Federal is part of the Seneca Nation Group (SNG) portfolio of companies. SNG is Seneca Holdings' federal government contracting business that meets mission-critical needs of federal civilian, defense, and intelligence community customers. Our portfolio comprises multiple subsidiaries that participate in the Small Business Administration 8(a) program. To learn more about SNG, visit the website and follow us on LinkedIn.
Our team of talented individuals is what makes us successful. To support our team, we provide a balanced mix of benefits and programs. Your total rewards package includes competitive pay, benefits, and perks, flexible work-life balance, professional development opportunities, and performance and recognition programs. We offer a comprehensive benefits package that includes medical, dental, vision, life, and disability, voluntary benefit programs (critical illness, hospital, and accident), health savings and flexible spending accounts, and retirement 401K plan. One of our fundamental principles is to offer competitive health and welfare benefits to our team members, providing coverage and care for you and your family. Full-time employees working at least 30 hours a week on a regular basis are eligible to participate in our benefits and paid leave programs. We pride ourselves on our collaborative work environment and culture, which embraces our mission of providing financial and non-financial benefits back to the members of the Seneca Nation.
Great Waters Federal is seeking a Junior Travel Claims Analyst to support one of our government customers.
Roles and Responsibilities include, but are not limited to:
Receiving, reviewing, and authorizing travel requests
Reviewing and processing travel vouchers
Ensuring travelers' compliance with the Federal Travel Regulation and the agency's travel policy in all transactions
Supporting travelers who are making and booking their own travel arrangements
Providing customer support by phone, email and through an automated help desk system
Tracking workload volume and supporting performance metrics reporting
Basic Qualifications:
Bachelor's degree OR HS diploma plus two years of relevant work experience (e.g., federal claims process, federal travel, or finance compliance)
Excellent customer service and attention to detail
Strong written and verbal communication skills
Demonstrated ability to manage multiple tasks and priorities in a fast-paced environment while consistently meeting deadlines
Desired Skills:
Experience coordinating travel from pre-travel authorization through voucher approval
Familiarity with the Federal Travel Regulation
Equal Opportunity Statement:
Seneca Holdings provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex/gender, sexual orientation, national origin, age, disability, marital status, genetic information and/or predisposing genetic characteristics, victim of domestic violence status, veteran status, or other protected class status. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation and training. The Company also prohibits retaliation against any employee who exercises his or her rights under applicable anti-discrimination laws. Notwithstanding the foregoing, the Company does give hiring preference to Seneca or Native individuals. Veterans with expertise in these areas are highly encouraged to apply.
$45k-80k yearly est. Auto-Apply 60d+ ago
Workers Compensation Claims Specialist, East
CNA Financial Corp 4.6
Claim processor job in Timonium, MD
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
* Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
* Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
* Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols.
* Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
* Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
* Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
* Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
* Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
* Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
* Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
* May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
* Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
* Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
* Demonstrated ability to develop collaborative business relationships with internal and external work partners.
* Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
* Demonstrated investigative experience with an analytical mindset and critical thinking skills.
* Strong work ethic, with demonstrated time management and organizational skills.
* Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
* Developing ability to negotiate low to moderately complex settlements.
* Adaptable to a changing environment.
* Knowledge of Microsoft Office Suite and ability to learn business-related software.
* Demonstrated ability to value diverse opinions and ideas
Education & Experience:
* Bachelor's Degree or equivalent experience.
* Typically a minimum four years of relevant experience, preferably in claim handling.
* Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
* Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
* Professional designations are a plus (e.g. CPCU)
#LI-AR1
#LI- Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$54k-103k yearly Auto-Apply 14d ago
Claims Analyst - Construction Project
Cornerstone Concilium
Claim processor job in Baltimore, MD
The Claims Analyst will perform a variety of "changes and claims" related contract administration tasks. An ideal candidate requires experience in transit projects through design, construction and commissioning phases. The Claims Analyst will be responsible for coordinating and reviewing claims / changes and engaging, strategizing, and working with various Program / Project teams to undertake the merit assessment, mitigation, and resolution of claims. The role requires commercial claim knowledge, and preferably also technical understanding, of multiple subject areas related to implementation of a large transit infrastructure projects.
Responsibilities
Maintain claims and early warnings' register.
Review alleged claims.
Carry out initial triage and risk assessment of claims.
Review project correspondence, and track and report on project claims.
Interface with the contractor and other stakeholders, as required, to gather additional details etc.
Attend various technical and commercial project working group meetings.
Requirements
Required Skills:
Critical thinking skills sufficient to apply analytical techniques to assess claims.
The ability to liaise effectively and to work closely with various multi-disciplinary technical and project controls teams
Proficiency with Microsoft Office Suite, particularly Excel.
Strong organization, time management, and prioritization skills with proven ability to balance competing tasks and meet deadlines.
Self-directed, detail-oriented, excellent at meeting deadlines with well-developed time management skills.
Excellent communication (both written and verbal), teamwork, and interpersonal skills.
Required Qualifications:
Bachelor's degree in engineering, business or other relevant degree.
1 - 4 years of relevant experience
Position Location
Field: Hybrid - 2 or 3 days in program office
$35k-63k yearly est. 60d+ ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claim processor job in Timonium, MD
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 *****************************************
How much does a claim processor earn in Towson, MD?
The average claim processor in Towson, MD earns between $29,000 and $85,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.
Average claim processor salary in Towson, MD
$49,000
What are the biggest employers of Claim Processors in Towson, MD?
The biggest employers of Claim Processors in Towson, MD are: