Claims Specialist 3 - 16476
Claim specialist job in Englewood Cliffs, NJ
Work Schedule: Onsite
Assignment Length: 6+ months
**NO C2C due to client restrictions**
Top Skills:
Claims Management - 2+ years of hands-on claims management experience
Customer Care
Legal knowledge/experience
Excellent written/oral communication and customer care skills
Strong Excel and PPT
The primary objective of the Claims Management Specialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management. The goal of the Claims Operations Specialist is to support the Product Safety Team by handling Claims with professionalism, care and urgency, making sure claims are reported and being handled in a timely manner. To achieve the highest performance, the person in this position is expected to maintain effective and timely communication with key customers, claims adjusters, stakeholders and leaders within the department, team, and cross-department where applicable.
Responsibilities:
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 client operations to manage all possible risks.
Pending Claim Management, KPI & TAT Management - Claim registration to closure
Product Verification
Liability Assessment by reviewing diagnosis results
Report on high-profile claims to the leadership
Qualifications:
2+ 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 possesses leadership qualities with an entrepreneurial approach
Must be able to analyze, make judgments, decisions and recommendations for ongoing and new projects or tasks
Able to apply critical thinking and imaginative solutions to analyze and present solutions to challenges based on data
Communicate professionally both verbally and through written correspondence
Explain reports and analysis to all levels of the organization
Sense of urgency, Flexible, self-motivated, self-organized self-directed, and results-oriented
Customer service focus with excellent relationship management skills
Team oriented, but able to work independently and manage multiple tasks
Able to perform complex quantitative analysis (Advanced Excel skills) to flag risk and report in timely manner
Claims Representative, Auto Property Damage - Independent Agent Channel
Claim specialist job in Parsippany-Troy Hills, NJ
The Auto Property Damage Claims Representative is responsible for managing Auto Property Damage claims within our “Auto PD Claim Unit.” This role demands a high level of customer service, patience, and professionalism while working in a fast-paced environment with significant phone interaction. Strong customer service, organizational, verbal, and written communication skills are essential. The ability to navigate adversarial situations with professionalism is critical. Comparative negligence claim handling experience is a plus but not required.
RESPONSIBILITIES
Policy Analysis:
Investigate and interpret policy provisions, endorsements, and conditions to determine coverage for automobile property claims.
Identify and investigate contested coverage claims that may require a roundtable discussion.
Claim Investigation:
Investigate auto accidents to assess liability by interviewing first- and third-party claimants, witnesses, investigating officers, and other relevant parties.
Secure and analyze pertinent records, documentation, and loss scene information to determine proximate cause, negligence, and damages.
Claims Management:
Evaluate and adjust reserves as necessary.
Prepare dispatch instructions for field personnel to inspect vehicles.
Negotiate and settle claims within individual authority limits and seek supervisor approval for claims exceeding authority or requiring additional guidance.
Maintain effective follow-up systems on pending files, advising insureds, claimants, and brokers on claim status.
Act as an intermediary between the company, preferred vendors, and customers to resolve disputes.
Ensure adherence to privacy guidelines, laws, and regulations in claims handling.
Subrogation and Legal Handling:
Investigate and initiate subrogation processes when applicable.
Handle and respond to special civil part lawsuits or intercompany arbitrations related to auto property damage claims.
Administrative Duties:
Manage a customer-focused phone environment by answering calls, returning voicemails, and responding to emails and text correspondence promptly.
Process incoming and outgoing mail timely and in accordance with state guidelines.
Complete other duties as assigned.
QUALIFICATIONS
Bachelor's degree required.
A minimum of 1 year of related PD claim experience is welcomed but not required.
Proficiency in personal computer skills, including Microsoft Office Suite.
Ability to prioritize and manage multiple tasks effectively.
Excellent communication, organizational, and customer service skills.
SALARY RANGE
The pay range for this position is $47,000 to $55,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
PERKS & BENEFITS
4 weeks accrued paid time off + 9 paid national holidays per year
Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
Annual 401(k) Employer Contribution
Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
Robust health and wellness program and fitness reimbursements
Various Paid Family leave options including Paid Parental Leave
Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
#LDNI
General Liability Claims Representative
Claim specialist job in Parsippany-Troy Hills, NJ
Berkley Luxury is seeking a Senior Claims Specialist to join our growing team in our new Parsippany, NJ office.
In this role, you'll manage a wide range of commercial lines casualty claims, including litigated matters, while delivering exceptional customer service and collaborating with a high-performing team.
What you'll do:
Conduct thorough investigations and analyze coverage, liability, and damages
Manage litigated claims and work closely with defense counsel
Negotiate resolutions through mediation and arbitration
Prepare reports and ensure compliance with regulations
What we're looking for:
5-7 years of experience handling commercial general liability claims
Strong litigation management and negotiation skills
Bachelor's degree (JD a plus)
This is a fantastic opportunity to join a company that values accountability, collaboration, and continuous learning.
If you're interested in learning more, let's connect!
Certification Specialist
Claim specialist job in Newark, NJ
Job Title: Certification Analyst
Duration: 06+ Months
Pay rate: $33.63/Hr. on W2 without benefits
Client: New Jersey - Transit-procurement
Job Description:
The Certification Analyst will be responsible for reviewing DBE re-evaluation applications, which include but are not limited to Personal Narratives (PN), Personal Net Worth Statements (PNW), Declarations of Eligibility (DOE), or Gross Receipts submitted by firms seeking certification under the current DBE federal program. This position requires advanced analytical skills to determine whether applicant submissions meet regulatory standards, demonstrate eligibility, and align with program requirements. The Specialist ensures fairness, accuracy, and consistency in certification decisions while upholding compliance with governing regulations. In addition, this role supports contract compliance functions and contributes to OBD special projects and initiatives as assigned.
Key Responsibilities
Narrative Review & Analysis
Read and critically evaluate Personal Narratives and Declaration of Eligibility (DOE) submitted with certification applications.
Review Personal Net Worth, Gross Receipts, or any other applicable financial statement to make sure applicants meet the economic standards as required by program regulations.
Identify gaps, inconsistencies, or insufficient evidence in applicant submissions.
Compliance & Decision-Making
Apply federal and state certification criteria (e.g., 49 CFR Part 26 for DBE programs).
Ensure decisions align with current regulatory changes, including IFR updates requiring individualized showings of disadvantage.
Document findings and provide clear recommendations for approval, denial, or request for additional information.
Communication
Communicate with applicants regarding deficiencies or clarifications needed in their narratives.
Collaborate with certification officers, legal staff, and program managers to ensure consistent application of standards.
Maintain accurate records of narrative reviews and decisions.
Prepare summary reports highlighting trends, common deficiencies, and recommendations for process improvement.
Qualifications
Bachelor's degree in Public Administration, Law, Business, or related field.
Demonstrated analytical and critical thinking skills.
Strong knowledge of certification programs (DBE/ACDBE, MWBE, SBE) and regulatory frameworks.
Excellent written communication skills for documenting findings and crafting clear, concise recommendations.
Experience in compliance, investigations, or regulatory review preferred.
Experience in Compliance Management System - (CMS - B2G)
Claims Examiner I - Commercial Auto
Claim specialist job in Parsippany-Troy Hills, NJ
Details
Claims Examiner I - Commercial Auto
Department:
Property & Casualty
Reports To:
Claims Supervisor
FLSA Status:
Exempt in all state except California
Job Grade:
9
Career Ladder:
Next step in progression could include Claims Examiner II
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner I to support our Property & Casualty department. Employees who live less than 26 miles from the San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA, and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. The Claims Examiner I is responsible for the timely investigation, evaluation and determination of settlement or denial of minor to moderate multi-line auto property and casualty claims with a docus on trucking and property damage claims. They will be handling claims from inception to closure. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills.
Investigate coverage, including evaluate insurance coverage problems and/or disputes
Investigate, evaluate and determine settlement value or denial of liability for all claims
Develop a measure of damage for each loss, establish and maintain appropriate reserves
Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure
Ensure appropriateness of all payments
Negotiate settlement of claim within individual authority ($15,000 unless otherwise noted)
Maintain and update action plans for each claim
May assign and coordinate with vendors, legal counsel, appraisers or experts as necessary
Facilitate between claimants, clients, brokers and attorneys in resolution of liability claims
Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers
Provide customer service and support to insureds and claimants
Assist in training of new employees
Attend meetings and educational seminars for professional development
Maintain required licenses
ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
High School Diploma or equivalent (GED) required for all positions
AA/AS or BA/BS preferred but not required
Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL
Additional State Adjuster License(s) may be required within 180 days
Maintain licenses and continuing education requirements in all states
Minimum of three years auto-claims handling experience, at least one-year commercial auto required
Trucking experience preferred
Knowledge of property and casualty insurance policies
Knowledge of auto insurance laws, codes, procedures, and liability concepts
Proficiency in investigation and resolution of minor to medium level auto physical damage casualty claims
Strong negotiation skills and ability to achieve optimal settlement results for clients.
Well-developed verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi-task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here
Lead Casualty Treaty Claims Specialist
Claim specialist job in New York, NY
Primary DetailsTime Type: Full time Worker Type: Employee
The Opportunity
Oversee and manage assumed reinsurance excess of loss and proportional business emanating from QBE Re's casualty and property book of business including an emphasis on Cedent audits. Ensure that all claims are being properly reported to QBE Re pursuant to the terms and conditions of the reinsurance contract(s).
Location: Ny- New York City
Work Arrangement: Hybrid (2-3 days in the office)
The salary range for this role is between $126,000 -$189,000 depending on experience
Your new role
Complete either on-site or remote reinsurance claim audits when necessary
Deliver quality claims service to our internal underwriters, actuaries, etc. and external partners (Brokers and Cedent's)
Manage a portfolio of reinsurance claims (via our ProSume system) in accordance with QBE Re's Claim Guideline and Procedures to ensure a favorable outcome.
Where necessary, conduct investigations on all assigned claims in order to provide timely and accurate facts for evaluation of each assigned claim
Interpret the applicable insurance and reinsurance contract(s) and apply that to the exposures presented with each assigned reinsurance claim
Complete Large Loss Reports (LLR's) for upper management when required
Resolve claims in a timely and fair manner and in accordance with all applicable laws, regulations and statutes
Collaborate with QBE's staff attorneys on coverage issues in order to formulate a strategy to achieve a favorable outcome
Review reserves on all assigned claim files and recommend changes (ACR's) where necessary to ensure claim and actuarial accuracy
Collaborate with other internal Centers of Expertise in a timely manner when indicated to facilitate the delivery of superior claims outcomes
Serve as an expert resource on complex claims or assigned claims requiring special handling
Undertake claims resolutions activities in accordance with claims best practices and Department of Insurance (DOI) compliance to support quality claim results
Provide the highest level of customer care, responsiveness, and satisfaction when managing assigned claims to deliver superior claim outcomes
Direct, control, and manage relationships with vendors to deliver accurate, timely, and cost-effective solutions
Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility
Required Education
Bachelor's Degree or equivalent combination of education and work experience
Required Experience
5+ years of Reinsurance Claims Experience and/or 10+ yeas of primary insurance claims experience
Preferred Competencies/Skills
Generate original, innovative solutions to difficult or unusual situations
Identify and locate information and facts which are necessary and relevant for the purposes of evaluating a claim
Financial and business acumen and awareness of financial responsibility
Quickly change direction when working on multiple projects or issues
Guide team to properly document investigation findings and preserve evidence in accordance with internal and external laws and procedures
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
Assume a methodical approach to a given situation and develop a systematic procedure as a response
Develop effective negotiation strategies and prepare a plan of action
Build and capitalize on beneficial internal and external relationships including competitors
Coach and encourage employees towards continuously improving performance and mentor team with feedback, on-the-job skill enhancement opportunities and career advice
Build and establish constructive and cooperative working relationships and open lines of communication
Utilize effective communication skills to influence and persuade decision makers
Preferred Education
Bachelor's Degree or equivalent combination of education and work experience
Preferred Education Specifics
JD degree or equivalent highly preferred
Preferred Experience
Experience handling Casualty and Property Insurance/Reinsurance claims
Experience in Auditing primary and umbrella insurance claims
Preferred Knowledge
Working knowledge of a Reinsurance Contract.
Experience managing Casualty Lines claims
Working knowledge of current and possible future policies, practices, trends, technology and information affecting the business and organization; knows how the business works
Working knowledge of relevant claims legal and technical knowledge for all US jurisdictions
Working knowledge of insurance policy and contract language
Working knowledge of business and management principles involved in strategic planning, resource allocation, leadership technique, and coordination of people and resources
Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate's professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE's annual discretionary bonus plan based on business and individual performance. We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team.
QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to:
Hybrid Working - a mix of working from home and in the office
22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis
Competitive 401(k) program with company match up to 8%
Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice
Tuition Reimbursement for professional certifications, and continuing education
Employee Network and Community - QBE actively supports six Employee Networks, and many ways to give back to your community
To learn more, click here: Benefits | QBE US.
Why QBE? What if you could have a positive impact - at work and in the world?
At QBE, we're enabling a more resilient future - for our customers, communities, environment, and for our people. We're building momentum to achieve something significant and know our people are at the center of our success.
Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you'll get to spend every day working with people who are passionate, talented and kind. And our international scale means we're big enough for your ambitions, yet small enough for you to make a real impact.
Join us now, so you can be part of our success - and we can be part of yours!
***************************************************
QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.
Equal Employment Opportunity:
QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.
This position is not eligible for visa sponsorship. Applicants must be authorized to work in the United States on a full-time basis without the need for current or future sponsorship.
Supplementary information
Skills:
Adaptability, Claims Settlement, Commercial Acumen, Conflict Resolution, Critical Thinking, Insurance Claims Processing, Intentional collaboration, Managing performance, Mentorship, Personal Initiative, Project Delivery, Regulatory Compliance, Reinsurance, Risk Management, Team Development
How to Apply:
To submit your application, click "Apply" and follow the step by step process.
Equal Employment Opportunity:
QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.
Auto-ApplyTrucking Claims Specialist
Claim specialist job in New York, NY
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
* Competitive compensation
* Healthcare benefits package that begins on first day of employment
* 401K retirement plan with company match
* Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
* Up to 6 weeks of parental and bonding leave
* Hybrid work schedule (3 days in the office, 2 days from home)
* Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
* Tuition reimbursement after 6 months of employment
* Numerous opportunities for continued training and career advancement
* And much more!
Responsibilities
Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service.
Key Responsibilities
* Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures.
* Review and interpret policy language to determine coverage and consult with coverage counsel when needed.
* Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies.
* Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information.
* Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts.
* Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards.
* Participate in file reviews, team meetings, and ongoing training to support continuous learning.
Salary Range
$95,000.00-$145,000.00 USD
The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training.
Qualifications
* Minimum of 3 years of trucking industry experience.
* Experience with bodily injury and/or cargo exposures.
* Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices.
* Strong analytical and negotiation skills, with the ability to manage multiple priorities.
* Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism.
* Possession of applicable state adjuster licenses.
* Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
Auto-ApplyClaims Specialist
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.
Executive Claims Specialist - Gig Economy
Claim specialist job in Morristown, NJ
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.
Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.
C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: **************
Job Description
S&S Transportation & Sharing Economy is seeking an experienced Executive Claims Specialist to join our dynamic team. In this role, you will provide expert oversight of Bodily Injury (BI); Property Damage (PD) and Personal Injury Protection (PIP) claims managed by Third-Party Administrators (TPAs), specifically arising from rideshare-related incidents. The ideal candidate will possess substantial expertise in complex injury claims, with a strong background in the rideshare sector.
What you will do for C&F:
TPA Oversight: Provide technical supervision and guidance for BI and PIP claims handled by TPAs, ensuring adherence to program standards and best practices.
Claims Management: Apply advanced knowledge to oversee rideshare claims, including coverage analysis and litigation management.
Technical Excellence: Drive optimal claim outcomes by controlling indemnity, expense, and litigation costs through timely reserving, trial preparation, and resolution strategies.
Auditing: Conduct regular audits of TPA-managed claims to ensure accuracy, timeliness, and compliance with established procedures.
Data Analysis: Review claims data, reserve adequacy, and performance metrics to identify trends and recommend process improvements.
Industry Awareness: Stay informed on evolving rideshare regulations, policy changes, and litigation developments.
Additional Duties: Perform other related tasks as assigned.
What you will bring to C&F:
Experience: Minimum 6-8 years handling complex bodily injury and litigated claims, with direct experience in rideshare claims required.
Expertise: In-depth knowledge of BI and PIP claim procedures; experience with high-value BI, PIP, and Property Damage exposures related to rideshare incidents.
Jurisdictional Knowledge: Extensive claims handling experience in Pennsylvania and New York preferred.
Education: Bachelor's degree required; law degree, professional designations, or insurance coursework a plus.
Licensing: Ability to obtain and maintain required state licenses.
Communication: Excellent verbal and written communication skills, with the ability to interact effectively at all organizational levels.
Technical Skills: Proficiency in Microsoft Office suite.
Travel: Occasional travel may be required.
Risk Transfer: Understanding of claims policy language and coverage necessary to evaluate Risk Transfer with PAP carriers.
What C&F will bring to you
Competitive compensation package
Generous 401K employer match
Employee Stock Purchase plan with employer matching
Generous Paid Time Off
Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing
A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
A dynamic, ambitious, fun and exciting work environment
We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $64,700.00 to a maximum of $121,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
#LI-AV1
#LI-Remote
Auto-ApplyTransactional Risk Claims Specialist
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 Claims Specialist for the Claims team.
The Transactional Risk Claims Specialist 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
Auto-ApplyTransactional Risk Claims Specialist
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 Claims Specialist for the Claims team.
The Transactional Risk Claims Specialist 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
Auto-ApplyClaims Specialist
Claim specialist job in New York, NY
SourceProSearch is seeking a Claims Specialist 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.
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Complex Claims Specialist-MPL
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 Claims Specialist 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 (Boston, Manhattan, West Hartford)
Salary range $120,000-$130,000 (Chicago, Atlanta)
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-AJ1
Work with amazing people and be part of a unique culture
Auto-ApplyClaims Specialist
Claim specialist job in New York, NY
We are seeking a highly skilled and detail-oriented Claims Specialist with expertise in handling No-Fault, Worker's Compensation and all other medical insurance claims. The ideal candidate must have 3+ years experience and will have a thorough understanding of regulatory requirements and processes associated with these types of claims, along with excellent communication and problem-solving skills. Must be available for employment Monday-Friday for 9a-5p employment.
Responsibilities:
Manage and process No-Fault insurance claims, including reviewing claim submission, verifying coverage, and ensuring compliance with regulatory guidelines.
Handle Worker's Compensation claims from initial filling through resolution, including investigating incidents, gathering relevant documentation, and coordinating with legal counsel as needed.
Conduct through investigation into claim validity, including medical records, and other relevant documentation.
Communicate effectively with claimants, insurance adjuster, and other stakeholders to facilitate the claims process and resolve issues in a timely manner.
Maintain accurate and up-to-date claim files and documentation, ensuring compliance with internal policies and regulatory requirements.
Obtain and verify insurance information for patients, including primary and secondary coverage, policy numbers, group numbers, and policy holder information.
Liase with insurance companies and third-party payers to confirm coverage details, policy benefits, and pre-authorization requirements.
Collaborate with medicalbillingteam to ensure accurate timely submission of claims and pre-authorizations.
Resolve insurance related issues and discrepancies, including denials and rejections, through effective communication and follow-up with insurance carriers.
Educate patients on insurance benefits, coverage limitations, and financial responsibilities, providing assistance with insurance inquiries and concerns.
Verify patient insurance coverage and eligibility.
Assist patients with insurance-related inquiries, explaining coverage details, copays, deductibles, and out-of-pocket expenses.
Prepare and submit insurance claims and billing statements.
Maintain confidentiality of patient information and ensure compliance with HIPAA regulations in all administrative activities.
Qualifications:
3+ years experience with medical insurance claims
Thorough understanding of regulatory requirements and processes
Excellent communication and problem-solving skills
Claims Examiner - Binding Authority
Claim specialist job in Morristown, NJ
At Coaction, we're a unique mix of leaders, achievers, thinkers, and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.
If you are looking for a career in the insurance industry this could be the right role for you! Coaction is looking for talented and driven candidates who combine strategic thinking, creativity, and pragmatic execution to drive business results. This is an exciting opportunity to join our organization as a Senior Claims Examiner. We are looking for motivated individuals who will contribute to our team and perform under strict timelines.
Responsibilities:
Provide expert claim handling in areas of coverage, investigation, evaluation, and resolution of complex third-party bodily injury and property damage claims.
Ability to comport with best practices in claims handling by timely investigating and evaluating on liability and damages.
Ability to analyze policies and review relevant contracts to explore risk transfer strategies and priority of coverage.
Draft appropriate coverage position letters.
Set timely indemnity reserves after conducting thorough investigation and evaluation on liability and damages.
Proactive approach towards negotiating claims towards resolution.
Manage expense reserves and engage in resolution strategies to obtain cost effective results.
Provide excellent customer service to insureds and brokers and timely advise underwriting of various losses.
May be called upon to perform other tasks and duties within the claims department as dictated by business needs.
Qualifications
Solid planning & organizational skills including time-management and prioritization.
2+ years of claims handling experience primarily handling general liability claims.
Must be willing to obtain adjuster's license in all states requiring licensure.
Must be willing to occasionally travel.
**This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.**
Salary range specific to for this role : $60,000-$97,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance. The offered rate of compensation will be based on individual education, experience, and qualifications. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.
Equal Opportunity Employer
Coaction is an Equal Employment Opportunity employer. Coaction's policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, and genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.
If your application is selected, you will receive an email directly from the Coaction Recruiting Team at ********************** asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
Auto-ApplyAuto Claim Representative, I
Claim specialist job in Morristown, NJ
**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 ******************************************************** .
Claims Specialist
Claim specialist job in Newark, NJ
Job Title: Remote Claims Specialist
Hourly Pay: $22 -$27/hour
We are looking for a skilled Claims Specialist to join our work-from-home team. In this role, you will assist in processing and reviewing insurance claims, ensuring all necessary information is gathered, and helping resolve claims efficiently. If you have strong attention to detail and enjoy supporting customers through the claims process, this is a great opportunity for you.
Key Responsibilities:
Assist in processing insurance claims, ensuring accuracy and timely resolution
Review claims documentation, including reports, medical records, and other evidence
Communicate with claimants, insurance adjusters, and third parties to gather information
Help resolve disputes or issues with claims and escalate when necessary
Maintain detailed records of claims progress and updates
Ensure compliance with industry regulations and internal policies
Provide excellent customer service and answer inquiries related to claims
Qualifications:
Experience in insurance, claims handling, or a related field
Strong attention to detail and organizational skills
Excellent communication and customer service abilities
Ability to handle multiple claims and prioritize effectively in a remote environment
Familiarity with insurance policies and claims procedures is a plus
Must have reliable internet and a quiet, dedicated workspace
Perks & Benefits:
100% remote work flexibility
Competitive hourly pay: $22 - $27
Paid training and professional development opportunities
Flexible work hours, including evening and weekend options
Opportunities for career growth in the insurance industry
A supportive and team-oriented work environment
Claims Processor
Claim specialist job in Florham Park, NJ
**Pay Rate:** Various based on experience, which may be below your state's minimum wage. Please take this into consideration when applying. **Remote Role** **Hours:** 8:30 AM - 5:00 PM EST Mon to Fri As a Claims Processor at Conduent, you'll have an opportunity to work in claims services. You will be surrounded by a culture that recognizes each person's contributions. Each day, you'll feel challenged and know you are making a difference in the lives of millions.
**Key Responsibilities:**
+ Review images of paperwork from benefits plan participants, utilizing all resources, procedures, and critical-thinking skills to determine eligibility for request and submit electronic transactions according to client and client/plan specific rules and IRS regulations and guidelines.
+ Must be able to work in a fast-paced environment with multiple transactions daily
+ Activities include:
+ Electronic document preparation and indexing into case management system.
+ Review and research document images of returned mail to determine validity of address. Notate and flag participant's account if determination is made that address is no longer valid.
+ Determine if requested transaction meets plan eligibility rules, as well as IRS regulations and guidelines.
+ Understand "gray areas" of IRS guidelines, effectively applying these guidelines to each case processed.
+ Review legal guardianship, conservatorship and power of attorney records if transaction is requested by a party other than the participant to determine if that party is authorized to request the specific transaction.
+ Review paperwork for completeness and accuracy, including completion of all required fields and notarization, if required, and inclusion of legal documents such as birth certificate copies. Paperwork can be 30 pages or more, especially pension packages.
+ Calculate eligible reimbursement based on available funds, requested amount, requested reimbursement, previous reimbursements and substantiated documentation.
+ Review history of requests, transactions, and call notes to determine if prior transactions disqualify the request, if previously incomplete paperwork is now complete, or if other exceptional conditions exist
+ Maintain and update case management system notes.
+ Follow-up on open items daily and close cases upon completion. Cases can remain open for days, weeks or months if initial paperwork is incomplete, or requires an exception determination or future event is pending.
+ Collaborate with other internal departments and third-party vendors to obtain exception processing information and address participant or client escalations.
+ May be tasked with peer review on work completed by other peers.
+ Associate will be measured on accuracy and speed
+ Must be able to navigate multiple computer tools simultaneously
+ Request assistance if special exception conditions are not covered well enough in knowledgebase applications and IRS regulations and guidelines.
**Qualifications and Skills:**
To be successful in this role you will:
+ High School Diploma required
+ An Associate's Degree in Business, Healthcare or related field preferred
+ 2+ years of experience in an analytical/claims role strongly preferred
+ Successful candidates may have experience in
+ Health & Welfare Claims Service Representative
+ Enrollment Data Analyst
+ Documentation Specialist in the field of Health Care, Eligibility Determination, or a similar field.
+ Experience in Health & Welfare Preferred (but not required)
+ Strong critical thinking and attention to detail skills required
+ Must pass an internet speed test (download equal to or greater than 25, upload equal to or greater than 5, Ping ms equal to or less than 175)
+ Must have the ability to connect with an ethernet cable to a modem/router
+ Live in one of the following states AL, AR, AZ, CO, CT, DE, FL, GA, ID, IN, IA, KS, KY, LA, ME, MI, MS, MO, NE, NV, NH, NJ, NM, NC, ND, OH, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
Join a rapidly growing organization that can support your career goals.
What you get:
+ Paid Training
+ Career Growth Opportunities
+ Full Benefit Options
+ Great Work Environment
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $33,600 - $42,000.
_We are currently NOT hiring in the following geographies,_ including but not limited to: _States: AK, CA, HI, MA, IL, MT & NY_
_Metro Areas: MN - Minneapolis, IL - Chicago, NY - New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, DC_
Professional Liability Claim Manager
Claim specialist job in New York, NY
Job Description- National Insurance Carrier is looking for an experienced EPL Claims Manager that is currently managing a team. Prior experience in EPLI & professional liability claims is preferred but not mandatory. Will need a minimum of 5 to 7 years experience in EPL and or professional liability claims.
JD preferred with good interpersonal skills.
Call for additional details.
Associate Claims Examiner
Claim specialist job in Summit, NJ
What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.
Join us and play your part in something special!
This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills.
Associate Claims Examiner will be responsible for the resolution of claims with the Prompt Resolution Team (PRT) of lower complexity and exposure. This position will have decision-making authority in the amount of $25,000 and work under the general direction of their manager. The ACE position supports all product lines in Casualty with particular emphasis on Binding and Commercial Wholesale Primary and Small Commercial Programs.
Job Responsibilities
* Confirms coverage of claims by reviewing policies and documents submitted in support of claims.
* Conducts, coordinates and directs investigation into loss facts and extent of damages.
* Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure.
* Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents.
* Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting.
Required Qualifications
* Must have or be eligible to receive claims adjuster license.
* Successful completion of basic insurance courses or achievement of industry designations.
* Ability to be trained in insurance adjusting up to two years of claims experience.
* 2-4 years of experience in general liability, construction defect, or related liability lines preferred.
* Bachelor's degree preferred
* Excellent written and oral communication skills.
* Strong organizational and time management skills.
#LI-Hybrid
US Work Authorization
US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.
Pay information:
The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $25 - $38.25 with a 10% bonus potential.
Who we are:
Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.
We're all about people | We win together | We strive for better
We enjoy the everyday | We think further
What's in it for you:
In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.
* We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life.
* All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance.
* We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.
Are you ready to play your part?
Choose 'Apply Now' to fill out our short application, so that we can find out more about you.
Caution: Employment scams
Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that:
* All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings.
* All legitimate communications with Markel recruiters will come from Markel.com email addresses.
We would also ask that you please report any job employment scams related to Markel to ***********************.
Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law.
Should you require any accommodation through the application process, please send an e-mail to the ***********************.
No agencies please.
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