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Claim specialist jobs in Maryland - 213 jobs

  • Claims Adjuster

    Agency Insurance Company of Maryland (AIC

    Claim specialist job in Maryland

    We have an immediate opening in our home office located in Hanover, Maryland. This inside position is responsible for conducting liability and coverage investigations, bodily injury and property damage evaluations, as well as successfully negotiating the settlement of first and third party injury and property damage claims. Qualifications: Qualified applicants should have 2 to 5 years of experience adjusting automobile accident claims. Bachelor's Degree or equivalent industry experience. Attention to detail and ability to multi-task. Excellent communication, organizational, and customer service skills. A high degree of motivation and team orientation. Proficiency with property damage estimates. PC experience with knowledge of Word, Excel, and Outlook.
    $48k-61k yearly est. 1d ago
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  • Claims Representative II

    Davies Talent Solutions

    Claim specialist job in Baltimore, MD

    Davies Claims North America seeks an experienced Claims Representative to manage claims related to MTA operations, including minor property damage and complex bodily injury. Reporting to the MTA Claims Supervisor, this role involves investigation, litigation management, and reserve evaluation for claims exceeding $25,000. Key Responsibilities: Handle a caseload of 150+ files, some with multiple claimants Investigate claims, manage litigation, and maintain detailed documentation Evaluate reserves and issue timely reports Uphold company values: Dynamic, Innovative, Connected, Collaborative Perform additional duties as assigned Requirements: High school diploma or equivalent Minimum 3 years of experience in auto property damage, bodily injury, and general liability claims Proficiency in Microsoft Office Familiarity with Medicare reporting requirements (Section 111) Benefits: Medical, dental, and vision coverage 401(k) with employer match Paid holidays and time off Life, short-term, and long-term disability insurance
    $37k-57k yearly est. 1d ago
  • Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

    Stout 4.2company rating

    Claim specialist job in Baltimore, MD

    At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
    $28k-34k yearly est. 2d ago
  • Senior Claims Analyst

    Accession Risk Management Group

    Claim specialist job in Maryland

    As a Senior Claims Specialist, you will manage 3rd party claims, providing technical guidance, support analytics, and liaise with TPAs, legal, and clients in the claims review process. You will be specifically be responsible for managing and overseeing claims in captive insurance programs. Captive insurance refers to a form of self-insurance where a company creates its own insurance company to cover its risks. In this role, you will work closely with clients, insurance brokers, and underwriters to ensure timely and accurate claims handling. Your Impact: Review and assess claims submitted by clients within captive insurance programs. Investigate and gather necessary information to determine the validity of claims. Collaborate with internal teams, external vendors, and legal counsel to resolve complex claims issues. Negotiate settlements and manage claims payments in accordance with policy terms and conditions. Provide guidance and support to junior claims specialists in handling claims effectively. Monitor claims trends and provide recommendations for process improvements to enhance efficiency and customer satisfaction. Maintain accurate claims records and documentation in compliance with regulatory requirements. Successful Candidates Will Have: Bachelor's degree in Insurance, Risk Management, Business Administration, or related field. Minimum of 5 years of experience in claims management, preferably in captive insurance or a related industry. Strong knowledge of insurance policies, coverage terms, and claims handling procedures. Excellent analytical and problem-solving skills with attention to detail. Effective communication and negotiation skills to interact with various stakeholders. Ability to work independently and prioritize tasks in a fast-paced environment. Professional certifications such as CPCU, AIC, or ARM are a plus. Risk Strategies is the 9th largest privately held US brokerage firm offering comprehensive risk management advice, insurance and reinsurance placement for property & casualty, employee benefits, private client services, as well as consulting services and financial & wealth solutions. With more than 30 specialty practices, the firm serves commercial companies, nonprofits, public entities, and individuals, and has access to all major insurance markets. Risk Strategies has over 100 offices and 5,300 employees across the US and Canada. Industry recognition includes being named a Best Places to Work in Insurance for five consecutive years (2018-2022) and to the Inc. 5000 list as one of America's Fastest Growing Private Companies. Risk Strategies is committed to being good stewards for our company, culture, and communities by having a strong focus on Environmental, Social, and Governance issues. Pay Range: $64,800 - $110,000 Annual The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role. Risk Strategies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies by visiting our careers page: ******************************** Personal information submitted by California applicants in response to a job posting is subject to Risk Strategies' California Job Applicant Privacy Notice.
    $64.8k-110k yearly Auto-Apply 60d+ ago
  • Workers Compensation Claims Specialist, East

    CNA Financial Corp 4.6company rating

    Claim specialist job in Timonium, MD

    You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI- Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
    $54k-103k yearly Auto-Apply 6d ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim specialist job in Timonium, MD

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

    Harriscomputer

    Claim specialist job in Maryland

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $37k-65k yearly est. Auto-Apply 34d ago
  • Auto Claims Specialist I

    Cox Communications 4.8company rating

    Claim specialist job in Maryland

    Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $18.22 - $27.36/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Arbitrator I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies. We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. 10 days of free child or senior care through your complimentary Care.com membership. Generous 401(k) retirement plans with up to 6% company match. Employee discounts on hundreds of items, from cars to computers to continuing education. Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. Uses appropriate levels/limits of financial approval authority to resolve cases. Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. Engages with supervisor/manager to determine if escalation is required. Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum A high school diploma or GED and less than 2 years of related experience. Accuracy and attention to detail. Organizational and time management skills. The ability to adapt in a fluid and changing environment. Preferred 1+ years of automotive or body shop experience. Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
    $18.2-27.4 hourly Auto-Apply 35d ago
  • Claims Processor (Must Have SAP is Required)

    Millenniumsoft 3.8company rating

    Claim specialist job in Maryland

    Claims Processor (Must Have SAP is Required) Duration : 4 Months contract Total Hours/week : 40.00 1 st Shift Client: Medical Device Company Job Category: Customer Service Level Of Experience: Mid-Level Employment Type: Contract on W2 (Need US Citizens Or GC Holders Only) Work days/Hours: M - F 9am - 5pm Job Description: The primary responsibility of this position is the investigation, analysis, resolution, trending and corrective action of all returns from US field engineers to support CAPA related to Return Material Authorization (RMA) procedure. Specific responsibilities include maintaining return tracker and analysis to supporting the resolution to closure and verification of CAPA effectiveness. Strong communications and problem solving skills. Ability to work independently. Competent using office software including Database management, MS Word, Excel, Internet Explorer, PowerPoint, and Outlook. Experience with SAP is required. Key responsibilities include: RMA/RGA - track shipments from FSE to Decon. Escalate any FedEx issues or incorrect tracking issues Maintain and report tracker for project purposes (region, FSE) Trending to be done by Brad team Provide root cause and FSE/DSM (Field Management) Monitor SMX closure compliance by Decon Support move to new building for Service Parts Process and setup
    $39k-64k yearly est. 60d+ ago
  • Senior Claims Analyst

    Risk Strategies 4.3company rating

    Claim specialist job in Maryland

    As a Senior Claims Specialist, you will manage 3rd party claims, providing technical guidance, support analytics, and liaise with TPAs, legal, and clients in the claims review process. You will be specifically be responsible for managing and overseeing claims in captive insurance programs. Captive insurance refers to a form of self-insurance where a company creates its own insurance company to cover its risks. In this role, you will work closely with clients, insurance brokers, and underwriters to ensure timely and accurate claims handling. Your Impact: Review and assess claims submitted by clients within captive insurance programs. Investigate and gather necessary information to determine the validity of claims. Collaborate with internal teams, external vendors, and legal counsel to resolve complex claims issues. Negotiate settlements and manage claims payments in accordance with policy terms and conditions. Provide guidance and support to junior claims specialists in handling claims effectively. Monitor claims trends and provide recommendations for process improvements to enhance efficiency and customer satisfaction. Maintain accurate claims records and documentation in compliance with regulatory requirements. Successful Candidates Will Have: Bachelor's degree in Insurance, Risk Management, Business Administration, or related field. Minimum of 5 years of experience in claims management, preferably in captive insurance or a related industry. Strong knowledge of insurance policies, coverage terms, and claims handling procedures. Excellent analytical and problem-solving skills with attention to detail. Effective communication and negotiation skills to interact with various stakeholders. Ability to work independently and prioritize tasks in a fast-paced environment. Professional certifications such as CPCU, AIC, or ARM are a plus. Risk Strategies is the 9th largest privately held US brokerage firm offering comprehensive risk management advice, insurance and reinsurance placement for property & casualty, employee benefits, private client services, as well as consulting services and financial & wealth solutions. With more than 30 specialty practices, the firm serves commercial companies, nonprofits, public entities, and individuals, and has access to all major insurance markets. Risk Strategies has over 100 offices and 5,300 employees across the US and Canada. Industry recognition includes being named a Best Places to Work in Insurance for five consecutive years (2018-2022) and to the Inc. 5000 list as one of America's Fastest Growing Private Companies. Risk Strategies is committed to being good stewards for our company, culture, and communities by having a strong focus on Environmental, Social, and Governance issues. Pay Range: $64,800 - $110,000 Annual The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role. Risk Strategies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies by visiting our careers page: ******************************** Personal information submitted by California applicants in response to a job posting is subject to Risk Strategies' California Job Applicant Privacy Notice.
    $64.8k-110k yearly Auto-Apply 60d+ ago
  • Outside Property - Experienced Claim Representative

    Travelers Insurance Company 4.4company rating

    Claim specialist job in Baltimore, MD

    **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $67,000.00 - $110,600.00 **Target Openings** 1 **What Is the Opportunity?** LOCATION REQUIREMENT: This field position services Insureds/Agents in the Maryland area. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. *You will be issued a company vehicle for this position.* Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. **What Will You Do?** + Handles 1st party property claims of moderate severity and complexity as assigned. + Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. + Broad scale use of innovative technologies. + Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. + Establishes timely and accurate claim and expense reserves. + Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. + Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. + Writes denial letters, Reservation of Rights and other complex correspondence. + Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. + Meets all quality standards and expectations in accordance with the Knowledge Guides. + Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. + Manages file inventory to ensure timely resolution of cases. + Handles files in compliance with state regulations, where applicable. + Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. + May provides mentoring and coaching to less experienced claim professionals. + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. + CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. + Must secure and maintain company credit card required. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. + This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + General knowledge of estimating system Xactimate. + Two or more years of previous outside property claim handling experience. + Interpersonal and customer service skills - Advanced. + Organizational and time management skills- Advanced. + Ability to work independently - Intermediate. + Judgment, analytical and decision making skills - Intermediate. + Negotiation skills - Intermediate. + Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate. + Investigative skills - Intermediate. + Ability to analyze and determine coverage - Intermediate. + Analyze, and evaluate damages -Intermediate. + Resolve claims within settlement authority - Intermediate. + Valid passport. **What is a Must Have?** + High School Diploma or GED. + One year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program. + Valid driver's license. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .
    $67k-110.6k yearly 15d ago
  • Claims Analyst (Level II)

    Collabera 4.5company rating

    Claim specialist job in Cockeysville, MD

    Since 1991, Collabera has been a leading provider of IT staffing solutions and services. We are known for providing the best staffing experience and taking great care of our clients and employees. Our client-centric model provides focus, commitment and a dedicated team to help our clients achieve their business objectives. For consultants and employees, we offer an enriching experience that promotes career growth and lifelong learning. Position Details: Industry: Financial Services Work Location: Hunt Valley, MD Job Title: Claims Analyst (Level II) Duration: 6+ months (Strong possibility of extension) Available Shift/s: • 11:00 am - 8:00 pm; Saturday, Monday, Tuesday, Thursday, Friday Job Description: • Receives incoming calls and assists customers with questions or issues regarding potential billing dispute and/or fraudulent related activity on their credit card account. • Takes appropriate action based on an evaluation of the customer's needs which may include, filing a new claim(s), updating and follow-up on existing claim(s), and/or reviewing appeals on denied claims. • Takes personal ownership to ensure that customer requests are processed quickly and efficiently, while maintaining compliance with industry regulations and bank procedures. • Responsibilities include but are not limited to: initiating claims using multiple systems and tools, providing first call resolution on inquiries, and may assist the customer in resolving disputes directly with the merchant. • May debit or credit customer's accounts, as appropriate. • May research and resolve other general customer account inquiries as appropriate and/or escalate issues on the customer's behalf while providing world class customer service. • Understand and adhere to established service level agreements and set appropriate expectation with the clients and customers regarding the claims process. Job Requirements: • Ideal candidate will have credit card knowledge in a customer service contact center. Qualifications MUST HAVE claims and/or customer service (call center environment) experience. Knowledge with credit card in a customer service contact center. Flexible with the work schedule.
    $72k-99k yearly est. 2d ago
  • Senior Claims Specialist - Worker's Compensation (Maryland based)

    Liberty Mutual 4.5company rating

    Claim specialist job in Baltimore, MD

    The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads. This role is remote. Grade 13-14 blended role handling all claims segments. Workers compensation experience should be residing in Maryland. Responsibilities: * Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate. * 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. * Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. * Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company. * Acts as senior technical professional on team, assisting team members with escalated issues. Mentors and trains new team members. Participates in Quality Review process. * Participates in conducting Suit Committees, Roundtables, Arbitrations, Mediations, field investigations and may assist in conducting closed file reviews. * Performs other duties as assigned. Qualifications * Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required. * Demonstrated leadership ability and time management skills to delegate work appropriately and organize resources effectively. * Demonstrates an expert level knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree or equivalent training plus 4 to 6 years directly related work experience (at least two of which should ordinarily be in a team leader capacity). * Licensing 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
    $76k-101k yearly est. Auto-Apply 9d ago
  • Claims Examiner. Workers' Comp

    Amergis

    Claim specialist job in Columbia, MD

    Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions. The Claims Examiner Workers' Comp understands and participates in every aspect of the WC claim process. Working in a team approach, the Claims Examiner WC will make decisions concerning reserve adjustments, develop a plan of action, and determine claim resolution. The Claims Examiner WC also works with the Adjusters, WC Manager, and fellow Amergis team members. Essential Duties and Responsibilities: + Manages full cycle claim management for assigned states to resolution + Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees in order to communicate status plans + Ensures legal deadlines are met + Monitors TPA's file resolution plans + Represents Amergis in depositions, mediation, and conference calls regarding assigned claim files + Provides analysis on the financial aspects of assigned claims files + Provides excellent customer service to injured workers + Prepares WC claim reports for department management team + Reviews, identifies and makes recommendations for maintaining control and/or reducing the claims experience (loss history) of the company + Authorizes or revise reserve requests + Coordinates with Benefits team during employee's absence + Coordinates with state programs and internal departments for transitional duty + Educates branch offices about all aspects of Workers' Compensation + Assists Manager in achieving overall department goals + Performs other duties as assigned/necessary Minimum Requirements: + College degree preferred; or equivalent work experience + 5 to 10 years of Workers' Compensation experience preferred + Some legal experience strongly preferred + Good organizational skills and attention to detail + Ability to work independently and cooperatively in a team environment + Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization + Computer proficiency, including Microsoft Office applications, required + Prior experience performing internet research + Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language is required At Amergis Healthcare Staffing, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical), Health Advocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death and Dismemberment Insurance, Voluntary Life and Accidental Death and Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, MilkStork, Transportation Benefit, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays *Benefit eligibility is dependent on employment status. Amergis Healthcare Staffing is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. This posting will remain active on job boards for 5 days from date of posting unless there is a good faith basis to extend the posting date. Please note that this pay range represents a good faith estimate of the compensation that will be offered for this position based on the circumstances. The actual pay offered to a successful candidate will take into account a wide range of factors, including but not limited to location, experience, and other variable factors. "Pursuant to the San Francisco Fair Chance Initiative, Amergis will consider for employment qualified applicants with arrest and conviction records"
    $37k-65k yearly est. 40d ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claim specialist job in Maryland

    At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
    $48k-60k yearly est. Auto-Apply 44d ago
  • Claims Examiner

    Healthcare Support Staffing

    Claim specialist job in Annapolis, MD

    Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Essential Functions: Reviews providers' disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures. Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness Perform any projects delegated by claims supervisor Qualifications Minimum Education/ Licensures/Qualifications High School Diploma or GED 1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting Healthcare Background Understanding of Medical Terminology Additional Information Shift: M-F 8am-5pm RTH or Temp-To-Perm (Any transition heavily depends on performance) Pay Rate: Up to 20/hour
    $37k-66k yearly est. 2d ago
  • Claims Specialist - Covered California

    IEHP 4.7company rating

    Claim specialist job in California, MD

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Under the direction of the Covered California Claims (CCA) Manager, the CCA Claims Specialist is responsible for analyzing, managing, and investigating complex and high-dollar healthcare claims that require in-depth research to determine accuracy and mitigate payment errors. The Claims Specialist is also responsible for adjusting first-pass and post-pay claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position collaborates with internal stakeholders, assists with claim audits (internal and regulatory) and utilizes strong analytical skills and independent judgement skills to make effective and accurate decisions. This position will also be responsible for responding to inquiries from the Provider Payment Resolution team on claims that may have been paid incorrectly. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. * Competitive salary * Telecommute schedule * State of the art fitness center on-site * Medical Insurance with Dental and Vision * Life, short-term, and long-term disability options * Career advancement opportunities and professional development * Wellness programs that promote a healthy work-life balance * Flexible Spending Account - Health Care/Childcare * CalPERS retirement * 457(b) option with a contribution match * Paid life insurance for employees * Pet care insurance Education & Requirements * Three (3) years of experience in examining and processing complex and high-dollar institutional and professional claims * Experience in a managed care environment helpful. Commercial, Exchange, and Medicare preferred * High school diploma or GED required * Associate's degree from an accredited institution preferred Key Qualifications * ICD-9/ ICD-10 and CPT coding and general practices of claims processing * CMS/DMHC and Affordable Care Act regulations and guidelines * Commercial line of business specifically Covered California/Exchange * Excellent communication and interpersonal skills * Excellent analytical, critical thinking, customer service, and organizational skills * Ability to think critically with the capacity to work independently * All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership Start your journey towards a thriving future with IEHP and apply TODAY! Pay Range * $25.90 USD Hourly - $33.02 USD Hourly
    $25.9-33 hourly 14d ago
  • Claims Representative I

    Legal & General America 4.7company rating

    Claim specialist job in Frederick, MD

    At Banner Life Insurance Company, we lead with heart and ambition. Every day, we transform purpose into progress, guided by our unwavering commitment to be better for our customers, clients, and communities, not just today but long-term as well. Our people are the driving force behind everything we achieve. Their passion, purpose, and pursuit of innovation empower us to deliver cutting-edge solutions that support those we serve, ensuring we are here for you, here for good and striving for better. We're a forward-thinking company energized by our work and how we show up for one another. Our culture is built on meaningful impact and genuine enjoyment, because we believe great work and great experiences should go hand in hand. By offering career development opportunities, comprehensive benefits, and programs that support your wellbeing, we help you thrive personally and professionally. We are here for you, here for good and here for better. The Claims Representative is responsible for the set up, research, review and processing of non-contestable claims and live rescissions within established productivity and quality standards. Complete all other claims related tasks to meet or exceed pre-defined productivity and quality standards. Complete other administrative duties and projects as directed by management. Responsibilities 1. Review and process live rescissions within established productivity and quality standards. 2. Prepare written communication to insureds regarding rescission of in force life insurance policies. 3. Set up, research, review and process non-contestable claims within established productivity and quality standards. 4. Review company records to confirm insurance coverage. 5. Review all beneficiary and title changes and collateral assignments for correctness and generate appropriate correspondence in accordance with state insurance regulations requesting appropriate claim requirements. 6. Open claims files according to departmental procedure. 7. Notify reinsurers of newly filed death claims. 8. Evaluate documentation submitted for processing of claim and confirm eligibility for payment utilizing knowledge of estates, trusts, minor beneficiary requirements, divorce statutes and other regulatory requirements. If documentation is insufficient, request correct or additional requirements needed in order to give the claim further consideration. 9. Correspond and communicate with claimants, attorneys, agents, reinsurers and other company departmental staff to discuss and/or resolve matters relevant to effective claims administration, including competing claim issues. 10. Review progress and status of pending claims with management and discuss problems and suggested solutions. 11. Follow up on all pending non-contestable claims within established regulatory requirements. 12. Follow established escheat procedures on pending claims review and run public records database searches as needed. 13. Process claim on administrative systems using the appropriate Post Mortem Interest statutes, dividend calculations, and contract provisions to reflect settlement or payment of claim to the appropriate party. 14. Send disbursement correspondence and document file reflecting interest and payment amount. 15. Document all activity to support claim file 16. Answer phones and respond to correspondence pertaining to the initial notification of death. 17. Keep abreast of “red flags” for fraud and identify potential issues to prevent payment of fraudulent claims including foreign death requirements. 18. Complete form 712's as needed. 19. As required, bill reinsurer for their share of the liability and update appropriate system. Communicate with reinsurers as needed on problem cases. 20. Keep abreast of claims related regulatory requirements. 21. Operate in a team environment and support other team members to enhance overall productivity. 22. Complete all other projects and tasks assigned by management. Qualifications Education High School diploma or equivalent Some college preferred Experience/Knowledge 1-2 years of experience in life or health claims or customer service/administrative position preferred. Skills Typing 35 WPM Proficiency in spreadsheet and word processing software Detail oriented Strong organization skills Outstanding verbal and written communication skills Superior customer service skills Good problem solving and negotiation skills Product knowledge and ability to understand basic contract language Good analytical skills Ability to work in a fast-paced environment Knowledge of Microsoft Office (Word and Excel) What's in it for you? The expected hiring compensation range for this position is $48,500 - $55,000 annually. This position is remote, operating on EST. The total compensation package for this position may include other elements, such as a sign-on bonus, long term incentives, and annual bonuses. This role is eligible to participate in the Annual Incentive Plan. The current target payment for the position is 3% of base salary, modified for corporate and individual performance. Bonuses are pro-rated based on start date. This role has 10 vacation days and 10 sick days that are accrued on a bi-weekly basis. Employees also have 9 paid holidays throughout the calendar year . We have a competitive compensation and benefits package focused on your overall wellbeing. Employee benefits include health, life, and dental insurance; 401K with company match up to 6% as well as a pension package; generous time off; and wellbeing initiatives throughout the year (we like doing fun stuff). We're big on professional development and we'll support and mentor you in your career progression and expect you to help us pay it forward by helping us develop tomorrow's leaders and growth-focused professionals. We value our teams and our communities and believe in giving back. Enjoy time off to volunteer for those causes that matter most to you! If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors. The Company reserves the right to change benefits plans at any time. We are an equal opportunity employer and value diversity at our company. We do not discriminate based on race, religion, color, national origin, sex, gender, gender expression, sexual orientation, age, marital status, veteran status, or disability status. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment. Please contact us to request accommodation.
    $48.5k-55k yearly Auto-Apply 13d ago
  • Baltimore Maryland Daily Claims Adjuster

    Cenco Claims 3.8company rating

    Claim specialist job in Baltimore, MD

    CENCO is a trusted claims solutions provider, working with leading insurance carriers to deliver timely and accurate claims handling. We are currently seeking a Daily Claims Adjuster in the Baltimore, MD area to support residential property claims. This opportunity is ideal for adjusters looking for consistent daily assignments with the flexibility of independent field work. What You'll Do: Complete on-site inspections for residential property losses, including wind, hail, fire, and storm-related damage Document damages thoroughly with clear photos and detailed reports Write accurate estimates using Xactimate or Symbility Communicate effectively with policyholders, contractors, and carrier partners Manage claim files efficiently while meeting carrier timelines and expectations What We're Looking For: Licensing: Active Maryland adjuster license or designated home state license Software Experience: Working knowledge of Xactimate or Symbility Equipment: Reliable vehicle, ladder, laptop, and standard adjusting tools Work Style: Detail-oriented, self-motivated, and comfortable working independently Responsiveness: Ability to accept assignments promptly and meet reporting deadlines Why Work with CENCO? Consistent residential claim volume in the Baltimore market Competitive per-claim compensation with dependable payment Support from an experienced claims team and streamlined workflows Long-term opportunities for steady daily work If you're seeking reliable daily residential claims work in the Baltimore area and want to partner with a company known for professionalism and support, we'd love to connect.
    $48k-60k yearly est. Auto-Apply 60d+ ago
  • Claims Reviews Specialist (Workers Compensation)

    Aerotek 4.4company rating

    Claim specialist job in Severn, MD

    **Aerotek has an immediate opening for a Claims Review Specialist (Workers Compensation) at the corporate office in Hanover, MD.** Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently. **ESSENTIAL FUNCTIONS** + Conducts and properly document all incident /accident investigations into our RIMIS system. Ensures the TPA thoroughly and properly investigates all initial claims. Monitor to ensure that TPA follows appropriate state workers compensation laws and defenses + Within the scope of authority, reviews and authorizes worker's compensation settlement offers to be made by the TPA + Effectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurate + Reviews costs associated with all claims handling and develops strategies to improve performance + Works with TPA to move claims toward closure + Partners with Safety, Human Resources and Corporate Legal to drive claims management + Makes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigator + Collect OSHA data and update OSHA field in GRA + Coordinates the colleague's release to transitional duty with the Return to Work Specialist and the Field Office; + Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trial + Initiates subrogation where appropriate with management's authorization + Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions + Review reserves and provide authorization to TPA, where appropriate within authority + Reviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustments + Monitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as needed + Participates in developing strategies to reduce claims frequency and severity + Establishes and maintains a file and diary on all open claims + Participates in communicating claims trends to Regional Safety Manager + Working with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and process + Attends training sessions, conferences and workshops to keep abreast of current practices, programs and legal issues for the purpose of conveying and/or gathering information required to perform functions + Authority level for settlements up to $70,000 + Authority level for reserves up to $80,000 **QUALIFICATIONS** + High School Diploma required + 3 years work experience in insurance, workers compensation claim management or risk management or + Ability to learn TPA system & generate requested reports Per Pay Transparency Acts: The range for this position is $60,000 - $80,000 + annual bonus potential of $4,000 Benefits are subject to change and may be subject to specific elections, plan, or program terms. This role is eligible for the following: Medical, dental & vision 401(k)/Roth Insurance (Basic/Supplemental Life & AD&D) Short and long-term disability Health & Dependent Care Spending Accounts (HSA & DCFSA) Transportation benefits Employee Assistance Program Tuition Assistance Time Off/Leave (PTO, Primary Caregiver/Parental Leave) Connect With Us! (********************************************************************************************************************************************************** Cookie Notice (***************************************** Cookie Settings Privacy Notices (******************************************* CA Notice at Collection CA Notice at Collection (for Employees and Job Applicants) (************************************************************************************ Your Privacy Choices Our People Are Everything. Aerotek Inc. provides staffing and services solutions in manufacturing, logistics, construction, aviation, facilities and maintenance. We provide the expertise, solutions and people required to rise to the challenges of North American industry. Headquartered in Hanover, Md., Aerotek operates a unified network of over 200 offices across North America, supporting more than 14,000 clients each year. Aerotek is an operating company within Allegis Group, a global leader in talent solutions. To learn more, visit: Aerotek.com . The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call ************ or email accommodation@aerotek.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position. **Job ID** _2026-13045_ **Category** _Risk & Compliance_ **Location : Location** _US-MD-Hanover_
    $23k-30k yearly est. 7d ago

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Top 9 Claim Specialist companies in MD

  1. CorVel

  2. Aerotek

  3. Mercury Insurance

  4. Philadelphia Insurance Companies

  5. Cox Communications

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  9. Sedgwick LLP

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