Claim specialist jobs in Union City, NJ - 200 jobs

BMO Capital Markets is a leading, full-service financial services provider. We offer corporate and investment banking, treasury management, as well as research and advisory services to clients around the world. #bmocapitalmarkets The Portfolio Management Director will support Global Market professionals in executing the first line of defense accountability for strong risk culture. The Portfolio Management Director provides robust multidimensional analysis and supports the Global Market team in a portfolio management function for Global Markets Corporate Banking Financial Institutions. Coverage comprises Bank and Non-Bank Financial Institutions with a focus on Insurance Companies, both domestic and international. This includes providing credit underwriting expertise for a variety of sub-sectors within the broader Insurance industry including US, Canada, and international insurers. This role requires origination and underwriting of non-lending Corporate Banking products (e.g. derivative products, securities financing, cash products, etc.), both bilaterally and through Agent relationships. The Global Markets Corporate Banking Portfolio Management function includes assisting in the origination and structuring of trading products transactions, providing credit expertise to the Global Market teams, oversee credit monitoring, working with internal stakeholders to manage and establish credit facilities and facilitate credit approvals across the various Global Market teams. ACCOUNTABILITIES + Contributes to growing / elevating the BMO and BMO Capital Market brand with a commitment to and presence in the community. + Operates as key member of the Global Markets portfolio management team managing credit risk and returns. + Uses industry expertise to cultivate relationships with new and existing clients and develop new client relationships within bank and non-bank FI sector with a focus on the insurance sector. + Monitors client, client industry and regulatory agencies for potential changes which may affect client's portfolio and business needs. + Prepares credit documentation (e.g. applications, memoranda, presentations) for internal and external stakeholders. + Reviews and continually monitors performance of existing accounts and client relationships. + Key First line of Defence and credit recommender for Global Markets transactions/facilities. + Oversees Business Analysts, Analysts, and/or Associates and their credit monitoring workload and initiatives. + Assists in monitoring country risk in counterparty locations + Reviews and provides feedback on framework and policy updates, and/or new initiatives. + Identifies opportunities for increased efficiency and improved service to internal and external clients. + Maintains awareness of all firm products and services offered and facilitates means of receiving continuous updates. + Supports the development and execution of strategic initiatives in collaboration with internal stakeholders. + Builds effective relationships with internal stakeholders. + Works with specialists as needed to support successful deal completion. + Understands complexity of transactions and related risk (credit, market, operational, legal/compliance, etc.). + Balances the Bank's risk appetite with the client needs in making recommendations to credit for the various Global Markets teams. + Provides feedback on and supports continuous improvement opportunities. + Identifies opportunities to find more cost-effective ways to impact the bottom line and drive profitability. + Integrates information from multiple sources to enable more efficient processes, enhanced analysis and/or streamlined reporting. + Reviews and guides work of Analysts and Associates to deliver business results. + Considers risk, internal controls, and compliance as part of day-to-day accountabilities and adheres to policies and procedures. + Focus is primarily on business/group within BMO; may have broader, enterprise-wide focus. + Provides specialized consulting, analytical and technical support. + Exercises judgment to identify, diagnose, and solve problems within given rules. + Works independently and regularly handles non-routine situations. + Broader work or accountabilities may be assigned as needed. KNOWLEDGE AND SKILLS + Graduate degree in Finance, or CFA/MBA and at least 8-10+ years bank and non-bank financial institution due diligence and credit analysis experience specifically covering the insurance sector (both domestic and international) + Credit analysis experience and understanding of counterparties and investment products. + Robust knowledge of lending and portfolio management parameters and objectives. + Excellent verbal presentation and written communication skills. + Strong credit solutions driven culture, knowledgeable of credit and derivative products including long-dated structured derivative products + Strong knowledge of trading products, market risk concepts, and trading products documentation (ISDA/CSA, GMRA, etc.), including documentation of non-standard collateral + Good knowledge of, and experience with, Corporate Policies/Standards, Financing Guidelines Commercial Lending Process and Directives, the Bank's credit culture and procedures, and general banking practices and regulations. + Successful completion of bank credit/lending program, internal or external, is preferred. + Thrive in a business aligned growth environment accessing Credit/Risk across various jurisdictions. + Strong ability to attentively review, assess, and provide detailed information daily on multiple projects in an organized manner. + Flexible, quick learner, self-motivated, confident, and comfortable working in a fast-paced environment. + Knowledge of and/or experience with loan workouts, management of problem accounts, structured finance, and securitization. + Must possess the ability to communicate in a professional and knowledgeable manner with internal partners. + Takes initiative to understand others; gets the cooperation of peers, colleagues; develops and maintains a broad network of relationships within the Bank. + Strong computer literacy. + Acts as a positive change agent to drive improved efficiency and effectiveness. **Salary:** Please note the base salary for this role is $250,000 USD. **Salary:** **Pay Type:** Salaried The above represents BMO Financial Group's pay range and type. Salaries will vary based on factors such as location, skills, experience, education, and qualifications for the role, and may include a commission structure. Salaries for part-time roles will be pro-rated based on number of hours regularly worked. For commission roles, the salary listed above represents BMO Financial Group's expected target for the first year in this position. BMO Financial Group's total compensation package will vary based on the pay type of the position and may include performance-based incentives, discretionary bonuses, as well as other perks and rewards. BMO also offers health insurance, tuition reimbursement, accident and life insurance, and retirement savings plans. To view more details of our benefits, please visit: ******************************************** **About Us** At BMO we are driven by a shared Purpose: Boldly Grow the Good in business and life. It calls on us to create lasting, positive change for our customers, our communities and our people. By working together, innovating and pushing boundaries, we transform lives and businesses, and power economic growth around the world. As a member of the BMO team you are valued, respected and heard, and you have more ways to grow and make an impact. We strive to help you make an impact from day one - for yourself and our customers. We'll support you with the tools and resources you need to reach new milestones, as you help our customers reach theirs. From in-depth training and coaching, to manager support and network-building opportunities, we'll help you gain valuable experience, and broaden your skillset. To find out more visit us at ************************** BMO is proud to be an equal employment opportunity employer. We evaluate applicants without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, transgender status, sexual stereotypes, age, status as a protected veteran, status as an individual with a disability, or any other legally protected characteristics. We also consider applicants with criminal histories, consistent with applicable federal, state and local law. BMO is committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation because of a disability for any part of the employment process, please send an e-mail to ************************** and let us know the nature of your request and your contact information. Note to Recruiters: BMO does not accept unsolicited resumes from any source other than directly from a candidate. Any unsolicited resumes sent to BMO, directly or indirectly, will be considered BMO property. BMO will not pay a fee for any placement resulting from the receipt of an unsolicited resume. A recruiting agency must first have a valid, written and fully executed agency agreement contract for service to submit resumes.

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, 8 paid national holidays per year, and 2 floating holidays 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”.

Senior General Liability Claim Representative - Property & Casualty Insurance Industry Union County NJ The management of accounts and the processing of claims related to litigated matters in hotels, real estate, hospitality, liquor liability, general liability, and bodily injury cases is a specialized function. This role necessitates an individual with a personality geared toward customer satisfaction. Responsibilities also include the negotiation of claims that are under litigation. Candidates should have at least 3 to 5 years of experience in handling middle market claims and possess a college degree. A valid New York adjuster's license is essential, while licenses from other states are considered a plus.

We are seeking a motivated and knowledgeable Commercial Insurance Specialist to join our business insurance team. This role is responsible for advising commercial clients on insurance products, quoting and binding policies, servicing accounts, and ensuring customer satisfaction. The ideal candidate has a strong understanding of P&C insurance products and thrives in a fast-paced, client-focused environment. Key Responsibilities: Develop and maintain relationships with commercial clients, ensuring their property and casualty insurance questions are answered. Provide quotes, online policy insurance policies, and process endorsements, renewals, and cancellations. Respond to client inquiries and follow up to ensure excellent customer service and retention. Stay current on products, underwriting guidelines, and regulatory requirements. Maintain accurate records in the CRM and agency management systems. Requirements: 2+ years of experience in commercial property and casualty insurance preferred. Active P&C insurance license is a bonus Strong phone skills Familiarity with small and mid-size business insurance products and rating tools. Strong communication and customer service skills. Ability to multitask, manage priorities, and meet deadlines. Ability to commute daily to our Woodcliff Lake, NJ office is required. This is an in-office position, Monday through Friday, from 8:30 AM to 5:30 PM. Business attire and a clean-shaven appearance are required each day. Preferred Qualifications: Experience working in an independent agency or with a direct writer. Bilingual abilities are a plus. Bachelor's degree or equivalent professional experience.

DETAILS Claims Examiner II - PIP Department: Property & Casualty Reports To: Claims Supervisor P&C FLSA Status: Exempt in all states but CA Job Grade: 11 Career Ladder Next step in progression could include Senior Claims Examiner 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 II to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, 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. As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe no-fault auto liability claims with an opportunity to handle Commercial Property, Inland Marine, and General Liability claims. These claims are typically moderate exposure and may entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. 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: Advanced 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 advanced analytical, decision making and negotiation skills. Investigate, evaluate, and determine settlement value of moderate level PIP commercial auto claims Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure. Ensure appropriateness of all payments Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers Attend meetings and educational seminars for professional development Maintain required licenses Conduct quarterly claim reviews with the client 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 5 years PIP claims handling experience NY PIP experience preferred Knowledge regarding the handling and resolutions of arbitrations relating to New York PIP Knowledge of laws and regulations regarding PIP in multiple jurisdictions. Primary jurisdictions would be NY, FL, and NJ Knowledge of tort law, civil procedure, and contract law Knowledge of auto insurance laws, codes, procedures, and liability concepts Knowledge of property and casualty insurance policies Negotiation skills Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment 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

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.

Company Details W. R. Berkley Corporation, founded in 1967, is one of the nation's premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriting and account executive units in seven regions. Berkley Environmental offers an array of coverages for virtually all classes traditionally known to have environmental liability exposures on both an admitted and non-admitted basis. We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers' compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Company URL: ********************************* The company is an equal opportunity employer. Responsibilities This is a mid-level examiner position in our liability claims department. This individual would be responsible for reviewing, processing, investigating, evaluating, negotiating and the settling of assigned property damage or bodily injury claims with the authority level generally up to $50,000.00. This position requires an understanding and knowledge of litigation management in multiple jurisdictions. Key functions include but are not limited to the following: Complete coverage analysis Formulate coverage letters Conduct the necessary investigation, either by phone, or through independent adjusters, to determine coverage, liability and damages. Evaluate, negotiate, and settle assigned property damage or minor bodily injury claims within authority granted, or seek authority for those claims in excess of authority. Obtain all required adjuster licenses within 180 days Manage and direct defense counsel Recovery/Subrogation Communication with both internal and external business partners. Qualifications Bachelors Degree 5-10 years experience handling basic to complex pollution and professional, liability claims. Understanding of the claims process Strong negotiation skills Some travel may be required customer service skills; negotiation and decision-making skills; communication skills and a confident disposition when dealing with people; organizational and time management skills; the ability to think strategically; initiative and the ability to adapt quickly to different situations; interpersonal skills; attention to detail and sound report-writing skills. JD is a plus The Company is an equal employment opportunity employer. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $57,000 - $115,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role

For a description, see PDF at: ************ transre. com/wp-content/uploads/2025/10/FAIRCO-Complex-Claims-Examiner. pdf

Location: Brooklyn, NY Salary: $52K-$80K The Billing and Claims Specialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials. Key Responsibilities for Billing/Claims Specialist: Billing & Claims Processing Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance Review authorizations, service hours, and eligibility prior to billing Ensure accurate coding and claim data in accordance with payer guidelines Process electronic and paper claims as required by payers Claims Follow-Up & Reconciliation Monitor claim status and follow up on unpaid, denied, or underpaid claims Investigate and resolve billing discrepancies and denials Submit corrected or resubmitted claims as needed Post payments, adjustments, and denials accurately into billing systems Reconcile remittance advice (EOBs/ERAs) with billed claims Authorization & Compliance Track MLTC authorizations, service limits, and expiration dates Ensure billing aligns with approved care plans and service authorizations Maintain compliance with Medicaid, MLTC, and insurance regulations Stay current on payer rule changes and billing requirements Qualifications for Billing/Claims Specialist: Required Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting Hands-on experience with MLTC billing and insurance claims Strong knowledge of Medicaid and managed care billing processes Proficiency with home care billing software and clearinghouses Excellent attention to detail and organizational skills

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

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

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required 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 Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional 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 Recipient of 2024 Cigna's Well-Being Award 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. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. 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. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture

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. ****************************

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.

**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 ******************************************************** .

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary Investigate claims and review the insureds' materials, pleadings, and other relevant documents Identify and review each jurisdiction's applicable statutes, rules, and case law Review litigation materials including depositions and expert's reports Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues Retain counsel when necessary and direct counsel in accordance with resolution strategy Analyze coverage, liability and damages for purposes of assessing and recommending reserves Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter Negotiate resolution of claims Select and utilize structure brokers Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines Strong time management and organizational skills Demonstrated ability to take part in active strategic discussions Demonstrated ability to work well independently and in a team environment Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word Willing and able to travel 10% Hybrid schedule, 3 days a week in office Education Bachelor's degree required. Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims Proper & active adjuster licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $95,000 - $150,000/year based on experience level Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.

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

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

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.