Claim specialist jobs in Oyster Bay, NY - 136 jobs
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Claim Specialist
Claim Processor
Liability Claims Manager
Claims Representative
Claims Adjuster
Insurance Claims Specialist
Marubeni America Corporation 4.6
Claim specialist job in New York, NY
To be considered, please apply through the link here.
We are seeking an experienced and independent Insurance ClaimsSpecialist with 7+ years of multi-line claims experience to manage and resolve claims across Marine Cargo, Property & Casualty, Automobile, Workers' Compensation, and Liability/Litigation.
The role also supports contract reviews by assessing insurance-related provisions to ensure alignment with policy coverage and claims protocols. The ideal candidate will also provide support to the Insurance Manager and General Manager on special insurance projects as needed, contributing to broader departmental goals and demonstrating flexibility beyond core claims duties.
ESSENTIAL JOB DUTIES:
Manage the end-to-end claims process for:
-Marine cargo/inland transit
-Commercial property and general liability
-Automobile (fleet and HNOA)
-Workers' Compensation (“WC”)
-Litigated liability claims, including bodily injury and third-party property damage
Handle end-to-end claims for marine, property, liability, auto (fleet/HNOA), WC, and litigated matters including bodily injury and third-party property damage.
Review policies to assess coverage, exclusions, deductibles, and retentions
Coordinate with brokers, carriers, adjusters, and Internal legal counsel
Support contract review by evaluating insurance clauses (limits, AI, Waiver of Subrogation) and identifying potential risk/coverage gaps
Draft claim notifications and ensure compliance with policy timelines
Provide loss history, reserve, and claim summaries to assist with renewal preparation
Collaborate with Legal, MGC, and MAC BU Operations to resolve claims
Participate in claim reviews and strategic discussions in recovery efforts
Support the GM and Insurance Manager with special insurance-related projects as needed, and demonstrate flexibility in cross-functional assignments.
MINIMUM EDUCATION REQUIREMENTS:
Bachelor's degree in insurance or business-related fields or equivalent experience.
MINIMUM EXPERIENCE AND CAPABILITY REQUIREMENTS:
7+ years of insurance claims experience across multiple P&C lines, including marine and litigated claims.
Strong working knowledge of insurance policy language, ISO forms, and manuscript policies.
Familiarity with contractual risk transfer principles and ability to analyze insurance-related clauses.
Experience coordinating with external counsel and adjusters on complex/litigated claims.
Proficiency in claims systems, Microsoft Word and Excel, and document management platforms.
Technically skilled in both claims handling and policy interpretation.
Detail-oriented with excellent judgment and risk awareness.
Confident in reviewing contract language from an insurance perspective.
Collaborative and able to communicate effectively with both technical and non-technical stakeholders.
Able to manage competing priorities and operate independently.
Must have the ability to work with deadlines and work in a fast-paced and dynamic work environment.
Requires excellent written and verbal communication skills.
Must be able to work in a multi-cultural business environment.
JOB-RELATED CERTIFICATION:
CPCU, ARM, or AIC designation preferred
$46k-71k yearly est. 5d ago
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Claims Adjuster
Network Adjusters, Inc. 4.1
Claim specialist job in Farmingdale, NY
Network Adjusters is seeking experienced General Liability and/or Construction Defect Claims Adjusters to join our third-party administrative insurance handling team. This role supports the investigation, evaluation, negotiation, and resolution of third-party construction defect claims, including property damage and liability exposures, while delivering consistent, high-quality claims management in alignment with industry best practices.
This position offers the opportunity to work within a trusted organization committed to integrity, reliability, and professional development through ongoing training and growth opportunities.
About the Role
Construction Defect Claims Adjusters are responsible for managing complex third-party claims related to construction projects from inception through closure. Claims may include third-party property damage, bodily injury, and other specialized construction-related exposures of varying complexity and severity. In this role, you will investigate losses, analyze policy language, evaluate damages, determine coverage, negotiate settlements, and handle litigated matters as needed while maintaining clear, professional communication with all involved parties.
Adjusters routinely conduct site inspections, gather statements from claimants, witnesses, and contractors, coordinate with external experts, and ensure all claim activity complies with state-specific regulations and Network Adjusters' Best Claims Practices. This is a desk-based role.
Responsibilities
Apply in-depth knowledge of General Liability and Construction Defect claims to manage complex third-party property damage, bodily injury, and related losses
Deliver high-quality customer service to insureds, claimants, carrier clients, and internal stakeholders
Review and analyze coverage by applying policy conditions, provisions, exclusions, and endorsements, and address jurisdictional considerations such as negligence laws, immunity, and financial responsibility limits
Investigate claims to determine liability and potential sources of recovery by contacting, interviewing, and coordinating with appropriate parties and external experts
Effectively manage litigated claims, including coordination with defense and coverage counsel
Establish, document, and maintain appropriate claim and expense reserves in a timely manner
Develop and execute plans of action for claim resolution, including diary management and timely follow-up
Determine settlement values using independent judgment, applicable limits, and deductibles, and negotiate settlements within assigned authority
Draft denial letters, reservation of rights, tenders, and other routine or complex claim correspondence
Identify and pursue subrogation opportunities when applicable
Prepare client-specific reports and detailed claim analyses, and consult with senior technical staff to ensure proper file handling
Document all claim activity in accordance with established procedures and Best Practices
Ensure compliance with all state-specific regulatory requirements and quality standards
Manage multiple competing priorities to ensure timely payments, follow-up, and claim resolution
Qualifications
2-5 years of claims handling experience, preferably in third-party General Liability and/or Construction Defect
College or technical degree, or equivalent relevant business experience
Ability to obtain and maintain required adjuster licenses, including completion of continuing education
Strong analytical, investigative, decision-making, and negotiation skills, with the ability to manage conflict effectively
Excellent verbal and written communication skills, with a customer-focused and empathetic approach
Strong organizational and time management skills with the ability to multitask in a fast-paced environment
High attention to detail, accuracy, confidentiality, and sound judgment
Proficiency in MS Word, Outlook, Excel, and standard business software
Bilingual proficiency preferred but not required
Compensation & Benefits
Salary: $75,000-$100,000 annually (based on licensure, certifications, and experience)
Training, development, and career growth opportunities
401(k) with company match and retirement planning
Paid time off and company-paid holidays
Comprehensive medical, dental, and vision insurance
Flexible Spending Account (FSA)
Company-paid life insurance and long-term disability
Supplemental life insurance and optional short-term disability
Strong work/family and employee assistance programs
Employee referral program
Location
📍 Farmingdale, NY (On-site)
Remote opportunities may be available for experienced candidates who meet all required criteria.
About Network Adjusters
Founded in 1958, Network Adjusters has built a reputation as a leading provider of insurance claims administration and independent adjusting services. Serving the insurance industry for nearly seven decades, Network Adjusters, Inc. brings together the best elements of third-party claims administration and independent adjusting services. From our primary offices in New York, Denver, and Kentucky to our national network of experts, our superior experience and ongoing training are the keys to successfully managing our clients claims and handling specialized insurance needs. All our Claim Directors have extensive backgrounds working with major insurance carriers, giving us a thorough understanding of factors critical claims handling. It all adds up to measurable results-the proof is in our extensive track record of settled claims and unmatched recovery abilities.
$75k-100k yearly 2d ago
Claims Specialist, APH
Swiss Re 4.8
Claim specialist job in Armonk, NY
Imagine a role where you can directly influence the profitability of a business, steer a diverse portfolio of claims, and build lasting relationships with clients. If you're a self-motivated individual who thrives on collaboration and career growth, this challenge is for you! If this sounds interesting, join us at Swiss Re, where we believe in fostering an environment that sparks the best ideas, maintaining a sensible work-life balance, and producing outstanding results through engaged employees. Together, we can help make the world more resilient.
About the Role
As a Reinsurance ClaimsSpecialist at Swiss Re, you'll manage a portfolio of asbestos, pollution, and health hazard (APH) reinsurance claims across various lines of business for both active and runoff portfolios. This role offers a unique opportunity to collaborate across functions, develop broad knowledge about the insurance and reinsurance industry, and help steer the business through data-driven insights and strong client partnerships.
Key activities of the role include:
* Steer a diverse portfolio of multi-line reinsurance claims, ensuring strategic performance through data analysis and industry insight.
* Analyze contractual obligations, establish and monitor reserves, and approve payments within authority to ensure timely, effective resolution.
* Apply advanced data analytics and reporting tools to manage the portfolio and identify emerging trends.
* Collaborate with Underwriting, Actuarial, and other teams to provide portfolio insights that inform business strategy and decision-making.
* Formulate, develop, and implement account management, including building and supporting client relationships.
* Participate in client meetings and audits to review claims, assess claims-handling practices, and support collaborative problem-solving.
* Deliver high-quality claims and client service, sharing industry knowledge and contributing to continuous improvement initiatives.
* Support internal stakeholders with research on claim topics, loss development, and contract wording issues, while ensuring compliance with governance, legal, and reporting requirements.
About the Team
You'll join a team of APH claims professionals known for deep technical expertise, collaborative spirit, and innovative problem-solving. We work closely with clients and internal partners to deliver exceptional claims management, identify potential exposures, and provide meaningful insights that shape our business. If you're curious, analytical, and motivated by teamwork and impact, this is the place for you.
About You
You excel in a dynamic environment, adept at juggling multiple priorities while maintaining professionalism. With strong interpersonal skills, you're confident communicating with clients, legal counsel, and senior management, and you bring curiosity and strategic thinking to every challenge.
Additional requirements include:
* Bachelor's degree required.
* At least 2-5 years of experience in claims, underwriting, insurance, reinsurance, or insurance-related legal work, including handling latent direct insurance claims.
* General understanding of and/or exposure to other insurance disciplines i.e., contract wording, accounting, underwriting.
* Ability and passion to manage a complex portfolio with critical analysis and innovative strategic thought.
* Confirmed ability to meet deliverables, implement plans, and conduct analysis.
* Excellent writing skills and proficiency in MS Office tools, claims systems and the ability and willingness to learn new systems.
* Excellent organizational and data analytics skills with openness for continued growth.
* Ability and willingness to learn new claims handling systems.
* Some business travel required.
The estimated base salary range for this position in Kansas City, MO is $84,000 to $140,000; for Armonk, NY is $90,000 to $150,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation.
About Swiss Re
Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world.
Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability.
If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience.
Keywords:
Reference Code: 136396
Nearest Major Market: White Plains
Nearest Secondary Market: New York City
Job Segment: Claims, Compliance, Data Analyst, Accounting, Actuarial, Insurance, Legal, Data, Finance
$90k-150k yearly 30d ago
Claims and Change Specialist
Luster National 3.9
Claim specialist job in New York, NY
We are seeking an experienced Claims and Change Specialist to join our team on major NY transit and infrastructure projects. This role is critical in managing project changes to ensure compliance with contractual requirements, budgetary constraints, and schedule commitments. The ideal candidate will have a strong background in claims and change management processes within large-scale heavy civil or transportation projects.
This is a long-term, on-site position located in New York City.
Responsibilities
may include, but are not limited to, the following:
Oversee and manage the change control process for a large-scale heavy-civil design-build contract, ensuring alignment with contract terms and client procedures while utilizing Unifier and other required tracking tools.
Evaluate and confirm change requests submitted by the Design-Builder, adhering to contractual timelines and client guidelines.
Conduct research and provide recommendations regarding the validity and merit of Notices of Change.
Develop comprehensive documentation for each change request, including cost and schedule impact assessments in collaboration with project controls teams (estimators and schedulers).
Partner with estimators, schedulers, and construction management teams to analyze potential impacts.
Keep accurate and up-to-date records of all change orders and approvals within the authorized project change log.
Lead meetings to address changes, resolve disputes, or clarify issues in coordination with construction management and contract administration teams.
Deliver consistent status updates and reports to the project team on a weekly basis or more frequently as required.
Assist in negotiating change orders by organizing sessions with the Design-Builder and PMT staff and preparing negotiation summaries.
Ensure adherence to client C&D standards and procurement requirements throughout all change management activities.
Provide support for audits and reviews related to change control processes.
Attributes
Excellent written and verbal communication and interpersonal skills. You are a persuasive communicator and skilled negotiator who builds trust across technical, legal, and executive audiences.
Excellent multi-tasking and organizational skills.
Strong analytical mindset with the ability to translate schedule and cost data into actionable commercial strategies.
Collaborative mindset that fosters teamwork, trust, and positive relationships and thrives in multidiscipline, owner-representative environments.
Natural curiosity, problem-solving abilities, and a passion for continuous improvement.
Minimum Qualifications
Bachelor's degree in Engineering, Construction Management, Business, or related field, or equivalent combination of education/experience.
7+ years of hands-on contracts, change order, or claims management experience on heavy-civil infrastructure programs, major transit or rail programs, including at least one project exceeding $500 million total contract value.
Experience with alternative delivery methods (e.g., DB, CM/GC, P3) and associated risk-allocation mechanisms.
Demonstrated successful negotiation strategy and achieving favorable commercial outcomes for public sector transit owners or operators.
Ability to interpret design documents, schedules, cost reports, and commercial terms to build clear entitlement narratives and quantum analyses.
Proficiency with industry standard project management, schedule/cost and/or EDMS tools (e.g., P6, EcoSys, Unifier, MS Project, Bluebeam, etc.)
Proficiency with Microsoft Office Suite/Office 365 (e.g., Outlook, Teams, Word, Excel, PowerPoint, etc.).
Preferred Qualifications
Master's degree in Engineering, Construction Management, Construction Law, or MBA.
One or more of the following certifications: Project Management Professional (PMP through PMI), National Contract Management Association (NCMA) certifications such as Certified Professional Contracts Manager (CPCM) or Certified Contract Manager (CCM).
Prior success steering claims through mediation, DRB, or litigation.
Proficiency with Microsoft Power BI, Oracle Cloud Analytics, or other dashboard KPI reporting software.
Compensation Details
The salary range listed for this role is $145k-$176k/year ($70-$85/hour). The final salary offered will be based on multiple factors and thoughtfully aligned with each candidate's level of experience, breadth of skills, total education achieved, certifications/licenses that have been obtained, geographic location, etc.
Just LOOK at the Benefits We Offer!
Unlimited flexible time off
Paid holidays
Paid parental leave
Health, dental, and vision insurance
Flexible spending accounts (healthcare and dependent or elder care)
Long-term disability insurance
Short-term disability insurance
Life insurance and accidental death and dismemberment
401(k) plan with guaranteed employer contribution
Formal career planning and development program
$2,500 annually toward professional development
Wellness program with monthly wellness stipend
Company cell phone or cell phone plan reimbursement
Free personalized meal planning and nutrition support with a registered dietitian
Free personal financial planning services
Employee assistance program
Employee discounts
Employee referral bonus
Specific plan details and coverage for each benefit noted above will be provided upon offer.
#IN-LNJS
Luster is committed to creating an inclusive work environment with a diverse workforce. All qualified applicants will receive consideration for employment without regard to criminal history, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. This employer participates in E-Verify. The employer will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS) with information from each new employee's I-9 to confirm work authorization.
All positions may be subject to a background check and drug test once a conditional offer of employment is made for any convictions directly related to its duties and responsibilities, in accordance with all applicable local, state, and/or federal regulations.
This job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.
Luster does not accept unsolicited resumes. In the absence of a signed agreement, Luster will not consider or agree to payment of any kind. Any unsolicited resumes presented to Luster personnel, including those submitted to Luster hiring managers, are deemed to be the property of Luster.
Please email ***************** for accommodations necessary to complete the application process.
$145k-176k yearly Auto-Apply 14d ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claim specialist job in Melville, NY
Marketing Statement:
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.
We are looking for a ClaimsSpecialist - 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 Specialist
Shiftsmart 4.3
Claim specialist job in New York, NY
Why Shiftsmart
We're building the Amazon of labor. We're a labor platform pairing end-to-end workforce management technology with a rapidly growing global network of 5M flexible workers to create scalable labor solutions for the largest companies and government agencies in the world like Circle K, Pepsi, Walmart, Starbucks and more. Our unique business model fractionalizes jobs down to shifts and makes it easy for workers to work across multiple companies through a digital marketplace. We're one of the fastest-growing startups in the country. We've grown 2-3x each year since we started, paid over $130M in wages to hourly workers, and raised $120M+ from top-tier investors including D1 Capital & Imaginary Ventures…
and we're only getting started.
Mission:
The mission of the Privacy and Compliance function is to ensure Shiftsmart processes and policies adhere to relevant legal and regulatory requirements and ensure positive & safe experiences for both users, clients, and company. You will be directly contributing in helping create and maintain a resource for both customers and users to assist with any privacy or legal related requests.
This role is based in New York City (HQ) with typically 4+ days in office
Outcomes:
This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.This position will evolve over time but some of your early responsibilities will include:
Gather, organize, and analyze information related to incidents and escalated complaints.
Support the creation of comprehensive written investigative reports based on gathered data.
Perform initial analysis of all escalated incidents and complaints, considering factors such as location, type of task, and the nature of the issue.
Coordinate closely with the Customer, Support, and Operations teams to compile relevant data, records, and other evidence necessary for investigative reports.
Maintain a robust tracking system to monitor the outcomes of all escalations and investigated cases.
Meet response time SLAs for communicating with partners, law enforcement contacts, and customer contacts.
Competencies:
Experience: You have 1-2 years of experience in employee relations, as a claims analyst, or in an investigatory role with the potential, motivation and ambition to grow and thrive in a fast-paced environment.
Communication: You have excellent communication skills and enjoy helping people feel heard, know how to ask the important questions, and analyze the relevant information into a report
Results driven: Takes pride in & has a track record of hitting or exceeding targets; persists in accomplishing objectives despite obstacles or setbacks. You thrive in an environment where success is measured in metrics and improvement
Collaboration: Ability to work closely with all areas of the company to be a problem solver. This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.
Highly organized: You plan, organize and execute in a highly structured way & relish bringing formality to ambiguity, ruthlessly prioritize, and feel organization is second nature to you.
Independent: Able to function with a high-level of autonomy once given a playbook.
Compensation philosophy
To provide greater transparency we share base salary ranges, which are based on role and level benchmarked against similar stage, high growth companies. Offers are determined based on multiple factors including skills, work experience, and relevant credentials.
In addition to competitive salaries and meaningful equity we offer the following benefits:
Comprehensive healthcare coverage: We cover 100% of employee premiums for medical, dental, and vision care (60-75% for dependents)
401(k) match program: We match 100% on the first 3% of your contributions and 50% on the next 2% for a maximum match of 4%
Generous, fully paid parental and family leave policies
Pre-tax commuter benefits
Collaborative office with fully stocked kitchen @ 1 World Trade in Manhattan
Equal opportunity employer
Shiftsmart is committed to creating a diverse environment and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Operating Principles @ Shiftsmart
Inspired by Leadership Principles @ Amazon
Execution Is Binary
We #GetShiftDone. We take immense pride in both the quality of our work and our relentless determination to deliver on our commitments. If we say we are going to do something, we do it.
We own the outcome with an unstoppable mindset through the finish line and are impatient to move the ball forward. This means we work really hard, execute with urgency, and ruthlessly challenge timelines for anything important. As a result, we do not defer responsibility to other teams or individuals. Instead, we take the problem as far as we can and only when needed ask others for help.
Each time a crisis or opportunity emerges we take the hill as one team, because we are allergic to the words
“it can't be done”
.
Missionaries, Not Mercenaries
We before me. We believe in our mission to build a better world for workers. We understand why our work matters and take seriously how it impacts our customers and our partners. This belief permeates everything we do from the strategic to the mundane.
We are energetic, ambitious, and want to win. We constantly raise the standards for ourselves and everyone around us. We show up for our customers, our partners, and most importantly our teammates, and make every effort to build lasting relationships with each of them.
We do not measure success based on our titles or the size of our empires. This also means we put the needs of the business before the details of our job descriptions. Rather than fight for a bigger piece of the pie, we fight to grow the entire thing and recognize this is how to grow our careers too.
Inputs > Outcomes
We work really hard. Fundamentally changing how labor works is not easy. It often requires long days, late nights, and weekends to deliver on our commitments. We lean into this challenge.
We focus on the process. We think in terms of value chains and appreciate that a bad process with a good outcome is simply dumb luck.
We lead with data. We use facts, not fiction, to build narratives and make decisions. To do this we prepare written memos in advance and resist the urge to engage in endless water cooler what ifs, because we value the time and attention of our teammates.
We hire and develop the best. When we decide to hire a new team member, we do so because we believe they will increase the talent density on our team. We view ourselves as leverage maximizers rather than inconvenience reducers and strive to increase the output of everyone we interact with.
Honesty Over Harmony
We share the truth even when it is painful. We do not, however, share the truth callously to hurt people's feelings or make them look bad. We also assume positive intent. If someone is not delivering in a way that we need, we ask them and tell them before assuming the worst.
We embrace mutual feedback. As people leaders we care more about our team's growth and success than how much others like us. As individuals we seek, accept, and apply feedback. We do not give or take feedback personally because we understand it enables us to learn and grow.
We tell the truth to ourselves. We reject a pollyannaish view of our world. Instead if something isn't going well that we are responsible for, we call it out. And when someone calls out their own truth that may be less optimal, we don't punish them for it.
We have the meeting in the meeting. If something is broken or we disagree, we call it out and say something in the moment even if it feels uncomfortable to do so. This means that if something is broken, we do not just accept it and complain later.
Invent & Iterate
We are ********************* categorically reject the phrase
“that is how it's always been done”
, and constantly discover new and better ways to do more with less. This means we are resourceful and often do things that don't scale, only to create ways to scale them later. We're builders.
We think BIG. At every level of the company, we embrace big, hairy, audacious, and transformative goals. We fear lack of progress and incremental thinking more than failing to deliver or falling short of an audacious goal. We believe courage means to try without fear and learn without ego.
We do not let perfect get in the way of better. When faced with the choice we prioritize delivering something, even if imperfect, over endless debate and alignment. We embrace good mistakes.
$58k-101k yearly est. Auto-Apply 56d ago
Auto Claim Representative, I
Travelers Insurance Company 4.4
Claim specialist job in Melville, NY
**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**
$55,200.00 - $91,100.00
**Target Openings**
4
**What Is the Opportunity?**
This role is eligible for a sign on bonus up to $10,000
Be the Hero in Someone's Story
When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most.
As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner.
In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process.
**What Will You Do?**
+ Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations.
+ Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates.
+ Determine claim eligibility, coverage, liability, and settlement amounts.
+ Ensure accurate and complete documentation of claim files and transactions.
+ Identify and escalate potential fraud or complex claims for further investigation.
+ Coordinate with internal teams such as investigators, legal, and customer service, as needed.
+ Insurance License: 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.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree.
+ Three years of experience in insurance claims, preferably Auto claims.
+ Experience with claims management and software systems.
+ Strong understanding of insurance principles, terminology with the ability to understand and articulate policies.
+ Strong analytical and problem-solving skills.
+ Proven ability to handle complex claims and negotiate settlements.
+ Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants.
**What is a Must Have?**
+ High School Diploma or GED required.
+ A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
$55.2k-91.1k yearly 60d+ ago
Complex Claims Examiner -FAIRCO
Transatlantic Reinsurance Company 4.8
Claim specialist job in New York, NY
For a description, see PDF at: ************ transre. com/wp-content/uploads/2025/10/FAIRCO-Complex-Claims-Examiner.
pdf
$51k-90k yearly est. 47d ago
Billing/Claims Specialist
P4P
Claim specialist job in New York, NY
Location: Brooklyn, NY Salary: $52K-$80K The Billing and ClaimsSpecialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials. Key Responsibilities for Billing/ClaimsSpecialist:
Billing & Claims Processing
Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance
Review authorizations, service hours, and eligibility prior to billing
Ensure accurate coding and claim data in accordance with payer guidelines
Process electronic and paper claims as required by payers
Claims Follow-Up & Reconciliation
Monitor claim status and follow up on unpaid, denied, or underpaid claims
Investigate and resolve billing discrepancies and denials
Submit corrected or resubmitted claims as needed
Post payments, adjustments, and denials accurately into billing systems
Reconcile remittance advice (EOBs/ERAs) with billed claims
Authorization & Compliance
Track MLTC authorizations, service limits, and expiration dates
Ensure billing aligns with approved care plans and service authorizations
Maintain compliance with Medicaid, MLTC, and insurance regulations
Stay current on payer rule changes and billing requirements
Qualifications for Billing/ClaimsSpecialist:
Required
Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting
Hands-on experience with MLTC billing and insurance claims
Strong knowledge of Medicaid and managed care billing processes
Proficiency with home care billing software and clearinghouses
Excellent attention to detail and organizational skills
$52k-80k yearly 6d ago
Transactional Risk Claims Specialist
Howden Group Holdings Ltd.
Claim specialist job in New York, NY
Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries.
People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden.
* Classification: Exempt/Full-time
* Reports to: Head of Claims for Transactional Risk
* Travel: 0-15%
* Salary: $150,000.00-$215,000.00
Role overview
DUAL North America is seeking a Transactional Risk ClaimsSpecialist for the Claims team.
The Transactional Risk ClaimsSpecialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice.
This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time.
Role responsibilities
* Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion.
* Assist with entering claim data into operational systems.
* Assist with quality control and performance management, to ensure high-quality claim handling.
* Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers.
* Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices.
* Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners.
* Perform other duties as assigned.
Key requirements
* Bachelor's degree required and law degree preferred.
* Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable.
* Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions.
* Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives.
* Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
* Ability to manage multiple competing priorities.
* Ability to adapt to evolving regulatory and legal environments.
* Complete assigned tasks correctly, on time and able to learn quickly.
* Self-motivated and demonstrating attention to detail.
* Be able to work independently for extended periods.
* Excellent written and verbal communication skills as well as general business understanding.
* Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment.
* If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team.
What do we offer in return?
A career that you define.
Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more.
What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community.
Our culture: people first
Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world.
The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key.
Diversity and inclusion
At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances.
What do we offer in return?
A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us:
* Our successes have all come from someone brave enough to try something new
* We support each other in the small everyday moments and the bigger challenges
* We are determined to make a positive difference at work and beyond
Reasonable adjustments
We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*.
If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require.
* Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more.
Permanent
$43k-77k yearly est. Auto-Apply 40d ago
Complex Claims Specialist-MPL
Hiscox
Claim specialist job in New York, NY
Job Type:
Permanent
Build a brilliant future with Hiscox
Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlement of Miscellaneous Professional Liability insurance claims. May be responsible for single or multi-country claims and will be responsible for all aspects of the claims, including liaise with external and internal business partners (e.g., outside experts and/or or legal counsel; underwriting) as required.
Bring your Passion and Enthusiasm to our Team! We are a fun, innovative and growing Claims team where you'll get the opportunity to learn multiple insurance products and interact with business leaders across the organization.
Please note that this position is hybrid and requires two (2) days in office weekly. Position can be based in the following locations:
Manhattan, NY
West Hartford, CT
Atlanta, GA
Chicago, IL
Boston, MA
The Role:
The Complex ClaimsSpecialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also:
Adjusts and resolves complex to severe claims that includes all phases of litigation
With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters
Reviews and analyses claim documentation and legal filings
Drives litigation best practices to lead defense strategy on litigated files
Mentors Claim Examiners
Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions
Identifies emerging exposures and claims trends
Identifies suspected fraudulent claims and tracks with special investigations unit
Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
Develops content and conducts training for claims team and underwriters as requested
The Team:
The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling.
Requirements:
8+ years of claims handling experience or 7-8 years litigation experience. (A JD from an ABA accredited law school may be considered as a supplement to claims handling experience.)
Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation
Advanced knowledge of coverage within the team's specialty or focus
Advanced knowledge of litigation process and negotiation skills
Experience in mentoring and training other claims examiners
Excellent verbal and written communication skills
Advanced analytical skills
B.A./B.S degree from an accredited College or University preferred
Additional Factors Considered:
Ability to act a subject matter expert within team
Demonstrated ability to work with minimal oversight
Experience attending and leading mediations, arbitrations and trials
Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects
Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers
Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation
Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars.
What Hiscox USA offers:
401(k) with competitive company matching
Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
Company paid group term life, short- term disability and long-term disability coverage
24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
Paid parental leave
4-week paid sabbatical after every 5 years of service
Financial Adoption Assistance and Medical Travel Reimbursement Programs
Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
Company paid subscription to Headspace to support employees' mental health and wellbeing
2023 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness program
Dynamic, creative and values-driven culture
Modern and open office spaces, complimentary drinks
Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
About Hiscox USA:
Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group.
Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism.
Diversity and flexible working at Hiscox:
At Hiscox we care about our people. We hire the best people for the job and we're committed to diversity and creating a truly inclusive culture, which we believe drives success. We also understand that working life doesn't always have to be ‘nine to five' and we support flexible working wherever we can. No promises, but please chat to our resourcing team about the flexibility we could offer for this role.
You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance)
Salary range: $125,000-$155,000
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
#LI-RM1
Work with amazing people and be part of a unique culture
$43k-77k yearly est. Auto-Apply 5d ago
Transactional Risk Claims Specialist
Hyperiongrp
Claim specialist job in New York, NY
Who are we?
Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries.
People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden.
Classification: Exempt/Full-time
Reports to: Head of Claims for Transactional Risk
Travel: 0-15%
Salary: $150,000.00-$215,000.00
Role overview
DUAL North America is seeking a Transactional Risk ClaimsSpecialist for the Claims team.
The Transactional Risk ClaimsSpecialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice.
This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time.
Role responsibilities
Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion.
Assist with entering claim data into operational systems.
Assist with quality control and performance management, to ensure high-quality claim handling.
Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers.
Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices.
Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners.
Perform other duties as assigned.
Key requirements
Bachelor's degree required and law degree preferred.
Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable.
Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions.
Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
Ability to manage multiple competing priorities.
Ability to adapt to evolving regulatory and legal environments.
Complete assigned tasks correctly, on time and able to learn quickly.
Self-motivated and demonstrating attention to detail.
Be able to work independently for extended periods.
Excellent written and verbal communication skills as well as general business understanding.
Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment.
If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team.
What do we offer in return?
A career that you define.
Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more.
What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community.
Our culture: people first
Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world.
The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key.
Diversity and inclusion
At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances.
What do we offer in return?
A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us:
Our successes have all come from someone brave enough to try something new
We support each other in the small everyday moments and the bigger challenges
We are determined to make a positive difference at work and beyond
Reasonable adjustments
We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*.
If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require.
*Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more.
Permanent
$43k-77k yearly est. Auto-Apply 42d ago
Claims Specialist
Sourcepro Search
Claim specialist job in New York, NY
SourceProSearch is seeking a ClaimsSpecialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office.
Job Responsibilities:
Format documents and communications for clients.
Liaise between third-party vendors and the firm.
Review documents (release/document verification) for production to defense counsel for quality control.
Calendaring and entry of case info into the database.
Perform intake and initial filtering of client inquiries.
Preparation of submissions involving large volumes of individual claims.
Run and analyze client data reports.
Organize documents and communications with clients.
Ensure that case documents accurately reflect a client's individual information.
Keep track of communications or developments relating to client cases and deadlines that may be applicable to individual clients.
Prepare and send client communications.
Communicate with clients telephonically, on occasion.
Work with attorneys to plan data gathering and settlement update workflows.
Analyze and summarize client inquiries to identify trends and patterns requiring further action.
Assist with the development of processes and technological systems for addressing large volumes of client interactions.
Skills/Requirements:
Proficient in the use of Microsoft Word and Excel.
Familiarity with Filesite preferred.
Familiarity with client management systems or databases preferred.
Strong technical skills and ability to quickly learn new litigation support software.
Strong written and oral communication skills and strong interpersonal skills.
Must possess great attention to detail.
Must possess analytical and critical thinking skills.
Strong organizational and time-management skills.
Ability to work independently while understanding the importance of teamwork.
Ability to manage workload consisting of multiple tasks.
The work shift for this position is 9:30 am-5:30 pm, five days a week, but the applicant must be willing and available to work overtime, both evening and weekends, when necessary.
****************************
$43k-77k yearly est. 60d+ ago
Claims Specialist 3- Staffing
Circet USA
Claim specialist job in Englewood Cliffs, NJ
Job Description
Circet USA is the leading provider of Network Services in North America, and we're looking for talented professionals to join our team. We specialize in engineering and construction services delivering comprehensive solutions across Inside Plant, Outside Plant, and Wireless networks to meet the evolving infrastructure needs of our customers.
With nearly 50 years of industry experience, we work with major telecom service providers, MSOs, cloud service providers, and utilities. At Circet USA, you'll have the opportunity to make an impact by helping to create customized solutions that address our clients' unique challenges. If you're passionate about innovation and thrive in a dynamic environment, we'd love to hear from you.
Circet USA's benefits package includes the following:
Medical, Dental, and Vision insurance
Digital Health & Wellness Support
Critical Illness, Accident, & Hospital Insurance
Short-term & Long-term disability
Group term & Voluntary life insurance
Flexible Spending and Health Savings Accounts
Paid Time Off & 401K
Company Discount Website
Responsibilities
We are seeking a highly skilled and experienced ClaimsSpecialist 3 to fulfill a staff augmentation role with Circet USA's customer. The primary objective of the ClaimsSpecialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management. The goal of the ClaimsSpecialist is to support the Product Safety Team by handling Claims with professionalism, care and urgency, making sure claims are reported and being handled in a timely manner. To achieve the highest performance, the person in this position is expected to maintain effective and timely communication with key customers, claims adjusters, stakeholders and leaders within the department, team, and cross-department where applicable.
ESSENTIAL DUTIES & RESPONSIBILITIES include the following. Other duties may be assigned:
Collaborate with team members in the Product Safety department, PL Insurance Carrier, outside law firm and 3rd Party administrators.
Generate daily/weekly/monthly reports, with analysis and recommendations
Manage 4-7 ongoing and ad-hoc projects that may include KPIs and Metrics
Ensure that all projects have required documentation as they move through the project tollgates
Communicate to Product Liability leadership on project status and escalation/decision points
Works cross functionally with HQ teams in Korea (occasional evening conference call) and SEA operations to manage all possible risks.
Pending Claim Management, KPI & TAT Management - Claim registration to closure
Product Verification
Liability Assessment by reviewing diagnosis results
Reporting on high-profile claims to the leadership
Qualifications
Bachelor's Degree (or equivalent experience)
3-5 years of hands-on claims management & customer care experience
Expertise in MS, Excel, and PPT
Proven capability to analyze data and develop a course of action
Proven ability to prioritize and manage multiple projects, meet deadlines and drive to resolution
Process, procedure, strategic planning and project development experience
Experience working with and influencing cross-functional teams.
Experience working within the insurance and/or home appliance industry a plus
Experience with product development or testing a plus
Experience working in a complex and wide organization and department
Claims Adjuster License a plus
Takes project ownership and possess leadership qualities with an entrepreneurial approach
Circet USA is an Equal Opportunity Employer - Veteran/Disabled. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by law.
$44k-79k yearly est. 21d ago
Insurance Claims Specialist
Ultimate Care Assisted Living Management
Claim specialist job in Ronkonkoma, NY
Job Description
The Insurance ClaimsSpecialist will work closely with the VP of Risk Management mitigating risks, promoting a safe environment for both residents and staff, supporting operational risk initiatives, and safeguarding company resources. This role is integral to supporting the financial health of the organization by collaborating closely with the finance team ensuring accurate invoicing, providing actionable data analysis, ensuring compliance and optimizing claims outcomes.
DUTIES AND KEY RESPONSIBILITIES:
Claims Management and Oversight
Manage and oversee workers' compensation, EPLI, GL, and PL claims from initial reporting through resolution.
Respond to inquiries and concerns regarding new and existing claims
Conduct timely and thorough investigations, coordinating with internal and external stakeholders, requesting/reviewing witness statements, video footage etc. and ensure all claims are accurately documented and supported.
Collaborate with claim and broker partners, build and maintain strong relationships to ensure effective claims handling and dispute resolution.
Maintain clear, consistent communication with Vice President of Risk Management, various team members, business partners, and other stakeholders regarding claims handling and their resolutions.
Compliance and Reporting
Ensure all claims processes adhere to state regulations and company policies, maintaining compliance with industry standards.
Prepare and maintain regular reports on claims status, costs, and outcomes for internal review and regulatory purposes.
Monitor claim trends and identify risk mitigation opportunities.
Financial Coordination and Invoicing
Coordinate with the finance team to ensure accurate claims invoicing, payment tracking, and budgeting.
Support the finance team with forecasting and financial planning related to insurance claims and associated expenses.
Work with finance team to place and monitor appropriate reserves and allocate funds.
Data Analytics and Reporting
Analyze claims data to provide insights into claim trends, financial impact, and risk management strategies.
Develop and maintain dashboards and reporting tools to communicate claims data with key stakeholders.
Use data insights to recommend and implement improvements to claims processes and cost-saving initiatives.
Collaboration and Communication
Work closely with VP of Risk Management, finance, HR, and community leadership teams to streamline claims processing and minimize organizational risk.
Serve as a primary point of contact for insurance carriers, third-party administrators, and internal teams on claims-related matters.
Provide regular updates to management on claims status, strategic initiatives, and risk trends.
Educate team members and on-site staff about claim reporting procedures, documentation best practices, and risk mitigation strategies.
Assist in training sessions on safety and risk prevention, fostering a culture of proactive incident management.
QUALIFICATIONS:
3-5 years of experience in insurance claims management, preferably within the healthcare or assisted living industry.
Associate's degree required.
Excellent customer service skills
Strong analytical and problem-solving skills to investigate and diagnose claim driven issues
Aptitude to investigate complaints for facts and recommend resolutions in a timely manner
Exceptional interpersonal, verbal, and written communication skills
Proven customer relationship and conflict resolution skills
Ability to develop and maintain strong working relationships with internal and external parties
Strong attention to detail and accuracy in data entry and record keeping
Must be willing to travel to various community locations for meetings, investigations, and internal audits as required.
$43k-76k yearly est. 21d ago
Claims Examiner
Harriscomputer
Claim specialist job in New York, NY
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.
$35k-65k yearly est. Auto-Apply 33d ago
Complex Claims Examiner
Transre
Claim specialist job in New York, NY
About Us
Since 1977 we have delivered first class solutions to insurers worldwide, by combining global reach with local decision making. We have built customer & broker relationships on years of trust, experience and execution. Through our people, our products and our partnerships, we deliver the capacity and expertise necessary to contribute to the sustainable growth of prosperous communities worldwide. To do so, our colleagues work with:
Integrity Work honestly, to enhance TransRe's reputation
Respect Value all colleagues. Collaborate actively.
Performance We reward excellence. Be accountable, manage risk and deliver TransRe's strengths
Entrepreneurship Seize opportunities. Innovate for and with customers.
Customer Focus Anticipate their priorities. Exceed their expectations.
We have the following job opportunity in our New York City office:
Description
We seek an experienced claims professional to join our growing FAIRCO team in our New York City office. FAIRCO is a subsidiary of TransRe Holdings, a Berkshire Hathaway company. As a member of FAIRCO, the Complex Claims Examiner will be responsible for adjusting Professional & Management Liability claims, with opportunities for experiences with other FAIRCO programs. Responsibilities will include but not be limited to:
Managing and adjusting primary and excess Professional & Management Liability claims, including private and public company, Directors and Officers, lawyers liability, accountants liability, financial institutions, cyber, employment practices and miscellaneous professional liability.
Proactively handling claims throughout the entire claim lifecycle from inception to resolution.
Analyzing policy coverage and drafting coverage analyses based on contract terms and claim details.
Evaluating liability and damages to determine the level of exposure to the insured and the policy.
Directing and closely monitoring assignments to defense counsel and experts in accordance with relevant guidelines.
Collaborating with underwriters, brokers, program partners, and insureds to ensure seamless claims resolution.
Traveling to and attending claims mediations, as required.
Developing and implementing claims handling strategies to mitigate risk and reduce claim expenses.
Requirements
The ideal candidate will possess the following knowledge, skills and abilities:
Extensive experience litigating or handling issues pertaining to complex Professional & Management Liability issues, with a focus on Directors and Officers coverage.
Experience leading mediations for Professional & Management Liability claims.
Experience evaluating coverage under various types of policies, drafting coverage correspondence, and participating in claims investigations.
Track record of effectively managing defense counsel and legal spend, assessing liability and financial exposure, and effectively negotiating cost effective, good faith claims resolutions.
Juris Doctorate preferred.
Willingness to travel up to 25% of the time for mediations, industry conferences, and client meetings.
Possession of, or willingness to obtain, a New York and other state adjuster's licenses.
Work Schedule
TransRe is supportive of an agile work schedule, which may differ based on individual roles, your local office's practices and preferences, marketplace trends, and TransRe's business objectives. This position is eligible for a hybrid work schedule with 3 days in the office per week, and 2 days remote.
Compensation
In addition to base salary, for this position, TransRe offers a comprehensive benefits package, paid time off, and incentive pay opportunity. The anticipated annual base salary range in New York for this position, exclusive of benefits, paid time off, and incentive pay opportunity is $140,000 - $180,000. This range is an estimate, and the actual base salary offered for this position will be determined based on certain factors, including the applicant's specific skill set and level of experience.
We are an Equal Opportunity Employer (EOE) and we support diversity in the workforce.
$35k-65k yearly est. Auto-Apply 60d+ ago
Claims Manager II, Hospital Professional Liability
Liberty Mutual 4.5
Claim specialist job in New York, NY
Ready to lead and shape Hospital Professional Liability claims strategy? Apply to this senior-level claims leader position, Claims Manager II.
Join a high-performing team leading the Hospital Professional Liability claims unit for IronHealth/NAS Claims. We're looking for a seasoned Claims Manager with deep Hospital Professional Liability experience who wants to lead a technical team, shape claims strategy, and drive measurable improvements across a portfolio of complex and high-severity matters consistent with the standards of Liberty International Underwriters.
*This position may have in-office requirements and other travel needs depending on candidate location. You will be required to go into an office twice a month if you reside within 50-miles of one of the following offices: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; or Westborough, MA. This policy is subject to change.
The salary range reflects the varying pay scale that encompasses each of the Liberty Mutual regions, and the overall cost of labor for that region, and based on you location you may not qualify for the top salary listed in the range.
Responsibilities
Responsible for performance, development and coaching of staff (including hiring, terminating, performance and salary management). Serve as technical resource not only for claims staff, but also cross-functional partners, including Underwriting (UW), Actuarial, Finance and Operations.
Work with claims team and external attorneys to review coverages, investigate claims, analyze liability and damages, establish adequate indemnity and expense reserves, develop strategies and resolve claims, including, but not limited to direct participation in mediation and arbitration and active participation in settlement discussions.
Perform quality assurance reviews/observations and provide feedback to team as well as action plan for development of team, where necessary.
Actively pursue all avenues of recovery including, but not limited to timely recovery of deductibles from insureds and manage subrogation activities.
Provide regular reports to claims management regarding losses either exceeding or likely to exceed the authority level in accordance with best practices. Must be able to present effectively, produce appropriate reports and develop team and train team in these skills
Partner with underwriting managers/team to provide excellent customer service and to market and meet with brokers, risk managers and reinsurers. Serve as external face claims leader for product line and demonstrate ability to forge and maintain relationships with external customers, effectively resolving concerns where necessary. Ability to effectively articulate the claims value proposition in claims advocacy meetings, account renewals and new business prospecting. Present at industry conferences or publishes external industry content.
Lead short to medium-term strategic claims activities/priorities for the product line, with alignment with the strategic priorities of IronHealth and NAS Claims. Oversee projects assigned by the department head.
Direct and manage the Claims participation and content for multidisciplinary reviews, monthly UW connectivity meetings, and quarterly actuarial meetings. Ensure timely feedback to senior management, underwriting and actuaries regarding relevant losses, account issues, and trends.
Assist and coordinate with underwriting team regarding new policy forms, product development and/or product rollouts and provide timely feedback to senior management and underwriting regarding recommendations.
Ability to achieve fluency in Loss Triangle interpretation and Product Level Profitability Understanding/Awareness.
Other duties as assigned, including delivery on established operational goals and objectives.
Qualifications
Qualifications - what will make you successful!
Bachelors' degree or equivalent training; advanced degrees or certifications preferred.
A minimum of 8+ years of relevant and progressively more responsible work experience required, including at least 2 years of supervisory experience.
At least 5 years claims handling within a technical specialty. Requires advanced knowledge of claims handling concepts, practices, procedures and techniques, including, but not limited to coverage issues, product lines, marketing, computers and product competition within the marketplace.
Requires advanced knowledge of a technical specialty. Knowledge of law and insurance regulations in various jurisdictions.
The ability to effectively interact with brokers and internal departments is also required. Strong verbal and written communications and organizational skills.
Strong negotiation, analytical and decision-making skills also required.
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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Commercial Auto Bodily Injury Claims Examiner
King's Insurance Staffing LLC 3.4
Claim specialist job in New York, NY
Job DescriptionOur client is actively seeking a seasoned Commercial Auto Bodily Injury Claims Adjuster to join their growing NYC team. This person will be responsible for managing a portfolio of moderate to complex claims involving commercial auto exposures, often including litigated files. From first notice to final resolution, you'll drive the claims process with precision, ensuring timely outcomes and outstanding service. Key Responsibilities:
Conduct thorough investigations and evaluations of commercial auto bodily injury claims, exercising sound judgment within designated authority limits to ensure prompt and fair resolution.
Manage a caseload consisting of 100 - 110 Commercial Auto files with bodily injury exposures.
Collaborate with claimants, legal representatives, and other stakeholders to negotiate settlements, issue payments, and bring claims to closure effectively.
Maintain accurate documentation and prepare detailed claim status reports to support transparency and compliance throughout the claims lifecycle.
Requirements:
5 to 7+ years of experience handling Litigated Commercial Auto Bodily Injury claims.
Strong analytical thinking and attention to detail to assess coverage, liability, and damages accurately.
Excellent negotiation and communication skills, with the ability to manage complex interactions confidently.
Proficiency in modern claims management software and related technologies.
Active adjusters license, highly preferred.
Salary & Benefits:
Competitive base salary ranging from $95,000 to $110,000, depending on experience.
Comprehensive benefits package, including health, dental, and vision insurance.
Generous PTO and paid holidays.
Clear pathways for career advancement.
401(k) plan with competitive employer matching.
How much does a claim specialist earn in Oyster Bay, NY?
The average claim specialist in Oyster Bay, NY earns between $33,000 and $98,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.
Average claim specialist salary in Oyster Bay, NY
$57,000
What are the biggest employers of Claim Specialists in Oyster Bay, NY?
The biggest employers of Claim Specialists in Oyster Bay, NY are: