Claims Processor -w2 only
Claim processor job in Reston, VA
Terms of Employment
• W2 Contract, 5 Months
• Candidates must reside in the Eastern or Central Time Zone.
Work with a leading healthcare organization's Federal Employee Program (FEP) Claims Department to make a direct impact on their operations. Due to a recent platform upgrade and an expansion of services, the claims team is facing a significant inventory backlog. We are seeking multiple detail-oriented and adaptable Claims Processors to join this team and help them drive down the inventory and ensure timely processing. This is a vital role where your contributions will be immediately felt. The team prides itself on being collaborative and supportive, even in a remote setting. You will…
• Process a high volume of HMO and PPO claims within the Facets system.
• Adapt to daily shifting priorities, processing various claim types including Medicare claims, paper claims, and subscriber-submitted claims.
• Utilize multiple applications daily to research and process claims, including Transaction Insight (TI Portal) for electronic claims and the Stored Information Retrieval (SIR) system for paper claims.
• Search for member authorizations using the Guiding Care database.
• Analyze claim data and interpret medical terminology from supporting documentation provided by clinical staff.
• Use Microsoft Excel spreadsheets to receive and manage claim inventories.
Required Qualifications
• High School Diploma or GED
• 1-3 years Claims processing, billing, or medical terminology experience.
• Hands-on experience processing claims directly within the Facets platform (legacy or G6).
• Demonstrated experience with the following systems:
o TI Portal (Transaction Insight)
o SIR (Stored Information Retrieval System)
o HealthEdge Guiding Care
o SharePoint
• A strong understanding of medical terminology.
• Proficiency with Microsoft Office, including Excel and Word.
• Excellent analytical skills and the ability to multitask in a fast-paced environment.
Disability claims processor
Claim processor job in Vienna, VA
Job Description
Hybrid: Pensacola, FL, Vienna, VA, or Winchester, VA - 3x a week starting in April 2026.
Shared Services Advisor - Make a Meaningful Impact
Join a dynamic team as a Shared Services Advisor where you'll provide essential guidance and support across various shared services functions. In this pivotal role, you'll optimize operations and serve as a trusted resource for employees navigating disability claims.
Key Responsibilities:
Employee Support & Communication: Serve as the first point of contact for employees after vendor approval of disability claims. Respond to incoming calls and make outbound calls to provide accurate information and compassionate guidance.
Case Management: Skillfully manage and resolve employee-submitted cases, including those requiring complex information and detailed guidance, ensuring timely and satisfactory outcomes.
Reporting & Data Validation: Create comprehensive reports and perform meticulous validations to ensure accuracy and compliance across all processes.
System Updates: Review and update employment statuses in Oracle HCM to maintain accurate records and ensure data integrity.
Vendor & Stakeholder Collaboration: Work closely with vendors, contractors, and advisors involved in processing disability payments to ensure seamless coordination and timely resolution of issues.
What You'll Bring:
Knowledge of shared services models and operational efficiency practices
Strong problem-solving and process improvement skills
Excellent communication and advisory abilities
Understanding of compliance and regulatory standards
Join this collaborative team where your contributions will directly impact employee experience and operational excellence. The client offers professional growth opportunities in a supportive environment where your expertise will be valued.
CC Pace is an equal opportunity employer. The organization celebrates diversity and is committed to creating an inclusive environment for all employees. CC Pace does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, or any other protected characteristic under federal, state, or local laws.
CC Pace is committed to employing only candidates who are legally authorized to work in the United States. To comply with the Immigration Reform and Control Act of 1986, all new employees, as a condition of employment, must complete the Employment Eligibility Verification Form I-9 and provide documentation that establishes identity and authorization to work. E-Verify will be used for employment verification as part of your onboarding process.
CC Pace values integrity throughout the hiring process. As part of standard verification procedures, candidates will be asked to provide documentation confirming employment history, education, and work authorization.
Claims Examiner- Property Casualty
Claim processor job in Richmond, VA
Kinsale Insurance is an Excess & Surplus lines insurer specializing in hard-to-place, small to medium sized commercial accounts. Kinsale is eligible in all states and writes a variety of Property, Casualty and Specialty lines. Given the experience of our staff and our control over the underwriting and claims processes, Kinsale offers unmatched underwriting flexibility to brokers placing difficult E&S accounts. Kinsale will consider offering terms on a wide range of risks including accounts with new or high hazard operations and businesses that have a poor loss history or that are located in high-risk venues. We are hiring a Claims Examiner to join our Casualty Lines Division here in Richmond, VA.
Responsibilities
Responsible for handling a wide variety of moderate to complex Property Liability claims under the supervision of a Claims Supervisor
Conducts investigation throughout all aspects of the claims process
Determines liability, evaluates exposure, and negotiates claims to resolution
Investigates and analyzes coverage; makes coverage determinations; drafts coverage correspondence; effectively communicates coverage determinations to policyholders and other stakeholders
Maintains accurate documentation/information in claim file
Handles claims in litigation filed against insureds; appoints, directs, and manages defense counsel
Proactively drives litigation toward resolution
Participates in and attends mediations to facilitate settlements
Qualifications
A minimum of 1- 2 years of experience handling property liability claims, or related industry experience
Superior written and oral communication skills
Strong analytical and problem-solving skills
Strong organization and time management skills
Exhibit skills in Microsoft Office products (Word, Outlook, Excel, Power Point)
Ability to work in a collaborative environment
Ability to multi-task
Strong negotiation skills
Proficiency in assigning and directing investigations
Education and Certifications:
Minimum of 2 years of professional work experience
Four-year college degree
At Kinsale we offer the following great benefits:
Competitive salary with performance-based bonus opportunities
Single and family health, dental, and vision insurance plans with a generous percentage of maximum HSA funds contributed by the company
Short-term and long-term disability
Life insurance
Matching 401(k), fully vested from first day of contribution
Generous paid time off and holidays
Yearly reimbursement for educational training and development opportunities
Promotion from within the company with clear goals and developed career paths
Kinsale values strong financial responsibility. A credit check will be conducted as a part of the selection process for roles that require sound judgement, trustworthiness, or access to sensitive information.
Insurance Claims Specialist
Claim processor job in Richmond, VA
The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager.
Specific Duties include:
Claims & Incident Management:
* Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to:
* Input and/or review all incidents reported in DPR's RMIS system.
* Maintain incident records in Insurance Team's document management system.
* Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements.
* Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities.
* Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable.
* Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate.
* Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date.
* Provide in-network aluminum certified repair shop information to drivers following an incident.
* Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement.
* When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form.
* Work with Insurance Controller on auto program claim reports
* Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed.
Fleet Vehicle Safety & Operations Policy Management:
* Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs
* Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training
* Ensure authorized driver list is kept current
* Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions
* Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy
Key Skills:
* Strategic thinking
* Ability to mentor and inspire others
* Integrity
* Team player
* Strong writing and communication skills
* Self-Starter
* Highly organized and responsive - ability to meet deadlines
* Detail Oriented
* Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs.
* Risk and dispute management - insured claims
Qualifications:
* A minimum of five years relevant insurance industry experience
* Previous experience in auto claims management highly desired
DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world.
Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek.
Explore our open opportunities at ********************
Auto-ApplyExecutive Claims Examiner, Construction
Claim processor job in Richmond, VA
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 the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure construction defect and construction property damage liability claims. The position will have significant responsibility for decision making and work autonomously within their authority.Responsibilities:
Confirms coverage of claims by reviewing policies and documents submitted in support of claims
Analyzes coverage and communicates coverage positions
Conducts, coordinates, and directs investigation into loss facts and extent of damages
Directs and monitors assignments to experts and outside counsel
Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure
Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
Negotiates and settles claims either directly or indirectly
Prepares reports by collecting and summarizing information
Adheres to Fair Claims Practices regulations
Assists in training and mentoring of specialists
Serves as technical resource to subordinates and others in the organization
Reviews and approves correspondence, reports and authority requests as directed by manager
Participates in special projects or assists other team members as requested
Travel to mediations, trials, and conferences as required
Represents Markel's claims expertise on external panels and industry forums
Coordinates loss information for senior business stakeholders and presents during monthly/quarterly business meetings
Contributes to maintenance of claims guidelines and best practice procedures
Delivers construction claims technical training to colleagues and external contacts as appropriate
Ensures effective vendor and litigation management on claims with a focus on minimizing indemnity exposure and mitigating vendor and legal expense
Steps in for manager to assume managerial duties when manager is unavailable or requires assistance
Qualifications:
Juris Doctor (JD ) Degree preferred
Must have or be eligible to receive claims adjuster license.
Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU) or
I-Lead or other Management Training
Minimum of 10 years of claims handling experience or equivalent combination of education and experience
Experience handling high exposure construction bodily injury and property damage claims
Market leading specialist knowledge within casualty construction lines
Expert policy language skills enabling accurate and consistent policy wording interpretation
Experience in negotiation, mediation and arbitrations
Experience in conducting technical claims audits and effectively following up on findings
Ability to manage claims outside of local jurisdiction where appropriate, including understanding of laws and regulations
Strong senior stakeholder management experience, both internal (underwriting, distribution, actuarial, finance and executive management) and external (brokers, major account clients)
Ability to influence claims stakeholders and to effectively direct claims strategy
Ability to lead within a team environment
Strong presentation skills
Excellent written and oral communication skills
Strong analytical and problem solving skills
Strong organization and time management skills
Ability to deliver outstanding customer service
Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)
Ability to work in a team environment
Strong desire for continuous improvement
Markel offers hybrid working schedules of 3 days in the office and 2 days remote.
#LI-Hybrid
#LI-SY
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 $97,520 - $134,090 with a 25% 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.
Auto-ApplyWorkers Comp Claims Representative
Claim processor job in Virginia
Company Details
Berkley Mid-Atlantic Insurance Group is a member of W. R. Berkley Corporation, one of the largest commercial lines property casualty insurance holding companies in the United States. With the resources of a large Fortune 500 corporation and the ability to operate with the closeness and flexibility of a small company, we exclusively work with select independent agents to ensure the future of business.
Company URL: ***********************
The company is an equal opportunity employer.
Responsibilities
As a Workers' Compensation Claims Representative, you will play a critical role in maintaining these standards by providing quality claim handling and superior service to our customers, while also engaging in indemnity and expense management. Success in this position will be driven by combining your experience in Workers' Compensation claims management with excellent communication and critical reasoning.
Investigate, evaluate, reserve, negotiate and resolve Workers Compensation claims in multiple jurisdictions and in accordance with Best Practices.
Promptly manage claims by completing essential functions including contacts, investigations, damages development, evaluation, reserving, and disposition.
Regularly handle claims involving complex coverage issues and severe injuries.
Develop action plans and handle the claims from assignment to early conclusion.
Review incoming mail daily, responding as needed to bring the claim to a prompt fair conclusion and seeking supervision as needed.
Work closely with medical management as needed
Prepare large loss reports as needed to include updated action plan and recommended reserves.
Maintain a current diary on outstanding claims.
Provide direction and guidance to defense attorneys and other experts while controlling expenses.
Meet or exceed specific objectives for service, quality, and reserving standards and other measurable performance items.
Perform other duties as assigned by the Claims Management.
Qualifications
5+ years of experience in a workers' compensation claims position
CPCU, SCLA or AIC designation is a plus.
Working knowledge of current state and local workers' compensation laws preferred
Experience in handling multiple jurisdictions is a plus
Proven ability to identify and address coverage issues, complete investigations to determine exposure, set timely reserves, and develop detailed action plans.
Excellent communication and negotiation skills.
Computer proficiency and working knowledge of Microsoft Office products.
Experience with Guidewire claims management system is a plus.
4-year college degree or equivalent work experience required.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
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. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.
Auto-ApplyAssociate Claims Specialist - Workers Compensation - Central Region
Claim processor job in Virginia Beach, VA
Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers exciting openings for Workers Compensation Claims Specialists within the Central Region! As a Workers Compensation Claims Specialist, the successful candidate will join a dedicated Claims Team, utilizing the latest technology to manage a caseload of routine to moderately complex claims. Responsibilities include investigating claims, assessing liability and compensability, evaluating losses, and negotiating settlements. The role involves interactions with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.
Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in February 2026.
This position may be filled as a Workers Compensation Associate Claims Specialist, Workers Compensation Claims Specialist I, or a Workers Compensation Claims Specialist II. The salary range posted reflects the range for the varying pay scale across various locations.
To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, and Virginia are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change.
Responsibilities
* Manages an inventory of claims to evaluate compensability/liability.
* Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
* Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
* Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
* Evaluates actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
* Performs other duties as assigned.
Qualifications
* Effective interpersonal, analytical and negotiation abilities required
* Ability to provide information in a clear, concise manner with an appropriate level of detail
* Demonstrated ability to build and maintain effective relationships
* Demonstrated success in a professional environment; success in a customer service/retail environment preferred
* Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent
* Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory
* Licensing may be required in some states
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
Auto-ApplyClaims Specialist - Executive Claims Specialist - Commercial Allied Health Claims
Claim processor job in Richmond, VA
Under minimal supervision, the Claims Specialist/Executive Claims Specialist manages a caseload of high complexity commercial insurance claims focused on Allied Health (assisted living and skilled nursing facilities). The Claims Specialist will review claims to analyze land determine applicable coverage, facts, liability, damages, plan and strategy for resolution in accordance with state and company guidelines. The Claims Specialist will function independently and act as a key resource on issues within area of specialty.
Duties and Responsibilities
Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service
Perform coverage, liability, and damage analysis on all claims assignments
Investigate allegations, determine facts based on evidence and interviews
Draft disclaimers and reservation of rights letters when coverage issues arise
Assign limited investigations and appraisals to independent licensed professionals
Manage a caseload of high complexity claims with delegated authority
Manage litigated files
Negotiate settlements, mitigate losses, and control expenses
Participate in and attend mediations to facilitate settlements
Maintain accurate documentation in claim files
Maintain a high level of communication internally with Claims management team and externally with insureds, claimants, attorneys and brokers
Act as a consultant providing technical expertise within specialty area to internal stakeholders
Provide technical guidance, assistance and training as needed for less experienced Claims professionals
Maintain a passing quality assurance score on all audits and QAs
Provide exceptional customer service to insureds, claimants, and attorneys, addressing inquiries, concerns, and providing regular updates on claim status
Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity
Handle claims in accordance with established James River Claims Best Practices
Other duties as required by management
Knowledge, Skills and Abilities
Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)
Expert level of expertise in claim handling and suit management
Expert knowledge of P&C insurance industry
Expert ability to effectively assess risk
Proficiency in MS Office (Word, Excel, Outlook)
Excellent written and verbal communication skills
Advanced analytical and organizational skills
Advanced negotiation skills
Ability to work independently and take initiative
Ability to exercise sound judgement in making critical decisions
Research, analysis and problem-solving skills
Ability to work in a team environment and accept feedback from Claims management
Ability to build effective relationships with business partners
Ability to organize complex information and pay close attention to detail
Ability to anticipate customer needs and take initiative to meet those needs
Ability to train and provide technical guidance to less experienced Claims professionals
Ability to successfully obtain the required state adjusters' licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter
Experience and Education
Claims Specialist
High school diploma required
Bachelor's Degree preferred
Advanced Degree or Juris Doctorate Degree preferred
Minimum of seven years of experience handling primary and excess claims-made and occurrence liability policies and claims.
Experienced in coverage, liability, and litigated claims related to health services claims, assisted living and skilled care facilities claims, life sciences (medical devices and products) claims, and professional liability claims.
Successful candidate will have strong written, verbal, injury evaluation, and negotiation skills
Adjuster license and/or certifications desired preferred
Executive Claims Specialist
High school diploma required
Bachelor's Degree preferred
Advanced Degree or Juris Doctorate Degree preferred
Minimum of ten years of experience handling primary and excess claims-made and occurrence liability policies and claims.
Experienced in coverage, liability, and litigated claims related to health services claims, assisted living and skilled care facilities claims, life sciences (medical devices and products) claims, and professional liability claims.
Successful candidate will have strong written, verbal, injury evaluation, and negotiation skills
Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL)
Project management and process implementation experience preferred
#LI-KS1
#LI-Remote
Property and Casualty Claims Specialist
Claim processor job in Roanoke, VA
Job Description
METIS | Location: Roanoke, VA | Full-Time
Are you seeking a professional career in Roanoke? Do you like solving problems, analyzing details, and helping people? At Metis, we take a unique approach to commercial insurance through administering self-insurance Risk Pools. If you are looking for a change and a challenge, we're looking for a dedicated Property and Casualty Claims Specialist to join our growing team.
What You'll Do:
Manage and resolve property and casualty and/or general liability claims
Assess and evaluate claims, conduct investigations, and ensure documentation is collected
Build relationships with members and help claimants navigate the claims process
What You Bring:
Bachelor's Degree or higher - required
7+ years of experience in property and casualty claims handling
Strong knowledge of policy analysis and associated legal issues
A team player with excellent communication and a customer focused mindset
*Please be sure to fully complete and upload the attached “Application for Employment” form along with your electronic application. Incomplete submissions may not be considered.
What We Offer:
Competitive compensation and performance bonuses
Individual dental, life, short-term & long-term disability insurance at no cost
Medical insurance with wellness incentives
Health Savings Account with annual company contribution
401(k) with 200% company match up to 6% of salary
Generous paid time off, including vacation, sick leave, and 11 paid holidays
Support for continuing education and professional growth
A beautiful campus with a collaborative, supportive, wellness-focused culture including onsite gym and café
Outside Property Claim Representative Trainee
Claim processor job in Reston, VA
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
$52,600.00 - $86,800.00
Target Openings
1
What Is the Opportunity?
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Chantilly, Fairfax, Sterling, Manassas, Springfield, areas. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. 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. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. 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?
* Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
* The on the job training includes practice and execution of the following core assignments:
* Handles 1st party property claims of moderate severity and complexity as assigned.
* Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
* Broad scale use of innovative technologies.
* Investigates and evaluates all relevant facts to determine coverage (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 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 attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
* 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.
* In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
* This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
* Perform other duties as assigned.
What Will Our Ideal Candidate Have?
* Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience.
* Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic.
* Verbal and written communication skills -Intermediate.
* Attention to detail ensuring accuracy - Basic.
* Ability to work in a high volume, fast paced environment managing multiple priorities - Basic.
* Analytical Thinking - Basic.
* Judgment/ Decision Making - Basic.
* Valid passport.
What is a Must Have?
* High School Diploma or GED and one year of customer service experience OR Bachelor's Degree.
* 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 *********************************************************
Medical Coding Appeals Analyst
Claim processor job in Norfolk, VA
Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
This position is not eligible for employment based sponsorship.
Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.
PRIMARY DUTIES:
* Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code.
* Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.
* Translates medical policies into reimbursement rules.
* Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.
* Coordinates research and responds to system inquiries and appeals.
* Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.
* Perform pre-adjudication claims reviews to ensure proper coding was used.
* Prepares correspondence to providers regarding coding and fee schedule updates.
* Trains customer service staff on system issues.
* Works with providers contracting staff when new/modified reimbursement contracts are needed.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required.
Preferred Skills, Capabilities and Experience:
* CEMC, RHIT, CCS, CCS-P certifications preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyMedical Coding Appeals Analyst
Claim processor job in Norfolk, VA
Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
This position is not eligible for employment based sponsorship.
Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.
PRIMARY DUTIES:
* Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code.
* Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.
* Translates medical policies into reimbursement rules.
* Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.
* Coordinates research and responds to system inquiries and appeals.
* Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.
* Perform pre-adjudication claims reviews to ensure proper coding was used.
* Prepares correspondence to providers regarding coding and fee schedule updates.
* Trains customer service staff on system issues.
* Works with providers contracting staff when new/modified reimbursement contracts are needed.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required.
Preferred Skills, Capabilities and Experience:
* CEMC, RHIT, CCS, CCS-P certifications preferred.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
MED > Licensed/Certified - Other
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Associate Claims Examiner
Claim processor job in Richmond, VA
Are you a recent college graduate? Or are you seeking a career change? Kinsale Insurance has seen proven success with candidates like you pivoting to our Associate roles! We promote from within and help you establish a career with advancement and financial success. Join our team as an Associate Claims Examiner in Richmond, VA.
Kinsale Insurance is an Excess & Surplus lines insurer specializing in hard-to-place, small to medium sized commercial accounts. Kinsale is eligible in all states and writes a variety of Property, Casualty and Specialty lines.
Responsibilities
Responsible for handling a desk of low-to-moderately complex, Property Liability claims under the supervision of a Claims Supervisor
Conducts investigation throughout all aspects of the claims process
Investigates, evaluates and drafts appropriate coverage correspondence to policyholders
Effectively communicates with policyholders, claimants and other stakeholders' status of claim
Determines liability, evaluates exposure, and negotiates claims to resolution
Maintains accurate documentation/information in claim file
Proactively drives claims toward resolution
Qualifications
Superior written and oral communication skills
Strong analytical and problem-solving skills
Strong organization and time management skills
Exhibit skills in Microsoft Office products (Word, Outlook, Excel, Power Point)
Ability to work in a collaborative environment
Ability to multi-task and handle desk of high-volume claims
Strong negotiation skills
Proficiency in assigning and directing investigations
Education and Certifications:
Associates or Four-year college degree, or relevant experience in the insurance industry
At Kinsale we offer the following great benefits:
Competitive salary with performance-based bonus opportunities
Single and family health, dental, and vision insurance plans with a generous percentage of maximum HSA funds contributed by the company
Short-term and long-term disability
Life insurance
Matching 401(k), fully vested from first day of contribution
Generous paid time off and holidays
Yearly reimbursement for educational training and development opportunities
Promotion from within the company with clear goals and developed career paths
Kinsale values strong financial responsibility. A credit check will be conducted as a part of the selection process for roles that require sound judgement, trustworthiness, or access to sensitive information.
Associate Claims Examiner
Claim processor job in Richmond, VA
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.
Auto-ApplyAssociate Claims Specialist - Workers Compensation - Central Region
Claim processor job in Virginia Beach, VA
Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers exciting openings for Workers Compensation Claims Specialists within the Central Region!
As a Workers Compensation Claims Specialist, the successful candidate will join a dedicated Claims Team, utilizing the latest technology to manage a caseload of routine to moderately complex claims. Responsibilities include investigating claims, assessing liability and compensability, evaluating losses, and negotiating settlements. The role involves interactions with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.
Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in February 2026.
This position may be filled as a Workers Compensation Associate Claims Specialist, Workers Compensation Claims Specialist I, or a Workers Compensation Claims Specialist II. The salary range posted reflects the range for the varying pay scale across various locations.
To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, and Virginia are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change.
Responsibilities
Manages an inventory of claims to evaluate compensability/liability.
Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
Evaluates actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
Performs other duties as assigned.
Qualifications
Effective interpersonal, analytical and negotiation abilities required
Ability to provide information in a clear, concise manner with an appropriate level of detail
Demonstrated ability to build and maintain effective relationships
Demonstrated success in a professional environment; success in a customer service/retail environment preferred
Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent
Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory
Licensing may be required in some states
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
California
Los Angeles Incorporated
Los Angeles Unincorporated
Philadelphia
San Francisco
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Auto-ApplyOutside Property Claim Representative Trainee
Claim processor job in Ashburn, VA
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
$52,600.00 - $86,800.00
Target Openings
1
What Is the Opportunity?
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Chantilly, Fairfax, Sterling, Manassas, Springfield, areas. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. 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. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. 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?
* Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
* The on the job training includes practice and execution of the following core assignments:
* Handles 1st party property claims of moderate severity and complexity as assigned.
* Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates.
* Broad scale use of innovative technologies.
* Investigates and evaluates all relevant facts to determine coverage (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 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 attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
* 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.
* In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
* This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position
* Perform other duties as assigned.
What Will Our Ideal Candidate Have?
* Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience.
* Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic.
* Verbal and written communication skills -Intermediate.
* Attention to detail ensuring accuracy - Basic.
* Ability to work in a high volume, fast paced environment managing multiple priorities - Basic.
* Analytical Thinking - Basic.
* Judgment/ Decision Making - Basic.
* Valid passport.
What is a Must Have?
* High School Diploma or GED and one year of customer service experience OR Bachelor's Degree.
* 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 *********************************************************
Medical Coding Appeals Analyst
Claim processor job in Norfolk, VA
Sign On Bonus: $1,000 **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
This position is not eligible for employment based sponsorship.
**Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.**
PRIMARY DUTIES:
+ Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code.
+ Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.
+ Translates medical policies into reimbursement rules.
+ Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.
+ Coordinates research and responds to system inquiries and appeals.
+ Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.
+ Perform pre-adjudication claims reviews to ensure proper coding was used.
+ Prepares correspondence to providers regarding coding and fee schedule updates.
+ Trains customer service staff on system issues.
+ Works with providers contracting staff when new/modified reimbursement contracts are needed.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required.
**Preferred Skills, Capabilities and Experience:**
+ CEMC, RHIT, CCS, CCS-P certifications preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Workers Comp Claims Representative
Claim processor job in Glen Allen, VA
Company Details
Berkley Mid-Atlantic Insurance Group is a member of W. R. Berkley Corporation, one of the largest commercial lines property casualty insurance holding companies in the United States. With the resources of a large Fortune 500 corporation and the ability to operate with the closeness and flexibility of a small company, we exclusively work with select independent agents to ensure the future of business.
Company URL: ***********************
The company is an equal opportunity employer.
Responsibilities
As a Workers' Compensation Claims Representative, you will play a critical role in maintaining these standards by providing quality claim handling and superior service to our customers, while also engaging in indemnity and expense management. Success in this position will be driven by combining your experience in Workers' Compensation claims management with excellent communication and critical reasoning.
Investigate, evaluate, reserve, negotiate and resolve Workers Compensation claims in multiple jurisdictions and in accordance with Best Practices.
Promptly manage claims by completing essential functions including contacts, investigations, damages development, evaluation, reserving, and disposition.
Regularly handle claims involving complex coverage issues and severe injuries.
Develop action plans and handle the claims from assignment to early conclusion.
Review incoming mail daily, responding as needed to bring the claim to a prompt fair conclusion and seeking supervision as needed.
Work closely with medical management as needed
Prepare large loss reports as needed to include updated action plan and recommended reserves.
Maintain a current diary on outstanding claims.
Provide direction and guidance to defense attorneys and other experts while controlling expenses.
Meet or exceed specific objectives for service, quality, and reserving standards and other measurable performance items.
Perform other duties as assigned by the Claims Management.
Qualifications
5+ years of experience in a workers' compensation claims position
CPCU, SCLA or AIC designation is a plus.
Working knowledge of current state and local workers' compensation laws preferred
Experience in handling multiple jurisdictions is a plus
Proven ability to identify and address coverage issues, complete investigations to determine exposure, set timely reserves, and develop detailed action plans.
Excellent communication and negotiation skills.
Computer proficiency and working knowledge of Microsoft Office products.
Experience with Guidewire claims management system is a plus.
4-year college degree or equivalent work experience required.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
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. Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplyAssociate Claims Examiner - 2026 College Graduate
Claim processor job in Richmond, VA
Are you graduating in 2026 - or looking to pivot your career? Kinsale Insurance is seeking motivated graduates and career changers for our Associate Claims Examiner role. This entry-level opportunity provides immediate responsibility, structured training, and long-term advancement in the insurance industry.
About Kinsale Insurance
Kinsale Insurance is an excess and surplus (E&S) lines insurer specializing in hard-to-place, small to medium commercial accounts. Licensed in all 50 states, we write across Property, Casualty, and Specialty lines. Our Claims team plays a critical role in delivering exceptional service and fair resolutions.
What You'll Do
A typical day as an Associate Claims Examiner may include:
Managing a desk of low-to-moderately complex property and liability claims.
Investigating and evaluating claims throughout the process.
Drafting and issuing coverage correspondence to policyholders.
Determining liability, evaluating exposures, and negotiating settlements.
Communicating with policyholders, claimants, and other stakeholders.
Maintaining accurate and complete claim documentation.
Driving claims toward timely resolution.
Qualifications
A successful candidate has:
Associate's or bachelor's degree (or relevant insurance experience).
Strong written and verbal communication skills.
Analytical and problem-solving ability.
Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint).
Organization and time management skills.
Ability to collaborate in a fast-paced environment and manage multiple claims simultaneously.
A compelling candidate also has:
Negotiation skills with proven results.
Proficiency in directing and overseeing investigations.
Hiring Timeline
Phone screens: October 2025 - January 2026
Interviews: January 2026
Offers extended following interviews
Start dates: May, June, or July 2026
Benefits
Competitive salary with performance-based bonus opportunities
Health, dental, and vision insurance with company HSA contributions
Short- and long-term disability coverage
Life insurance
Matching 401(k), fully vested immediately
Generous paid time off and holidays
Reimbursement for training and professional development
Clear promotion paths and career advancement from within
Kinsale values strong financial responsibility. A credit check will be conducted as a part of the selection process for roles that require sound judgement, trustworthiness, or access to sensitive information.
Claims Litigation Specialist
Claim processor job in Richmond, VA
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! Claims Paralegal Specialist (CPS) is a Claims department resource on Markel's Associate General Counsel team. The CPS primarily acts as an internal resource and partner to Claims Examiners, providing claim assistance and litigation support. The ideal CPS must have a claims and/or litigation background and demonstrate effective communication skills. The CPS will develop and maintain relationships with internal claims department partners by assisting in various aspects of the claim investigation process, claims litigation and special projects. Above all, the CPS is responsible for ensuring that Claims Examiners access to quality in-house paralegal assistance, while exemplifying Markel's culture of honesty, fairness, zealous pursuit of excellence and commitment to its customers, associates and community.
Partner with Markel Claims Examiners to provide first-in-class paralegal support for all aspects of claim investigation and litigation support
Monitor trials and provide daily reporting to Claims leadership
Coordination with outside counsel for litigation and trial preparation
Perform jury verdict research
Review and summarize documents, including contracts, pleadings, other legal documents and medical records
Research court records and obtain documents from court docket systems
Search and obtain corporate records
Assist with special projects
Education:
Bachelor's degree,
Paralegal certificate,
Insurance Adjuster License, preferred
Work Experience:
4-6 years working as a paralegal in a law firm, insurance company or corporate legal department
Skill Sets
Focus on customer service and relationship-building to create and maintain strong partnerships with Markel Clams
Comfortable and experienced working with AI
Highly motivated self-starter
Ability to work independently and manage multiple projects at the same time
Focus on operational efficiency and collaboration
Excellent written and oral communication skills
Strong analytical and problem-solving skills
Strong desire for continuous improvement
Strong organization and time management skills
Comfortable working as part of a hybrid team
Flexibility and attention to detail
Willing to travel
#LI-Hybrid #piq
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 $32 - $44 with a 12% 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.
Auto-Apply