Post job

Claims director full time jobs - 21 jobs

  • Director Claims

    Ryder System 4.4company rating

    Columbus, OH

    The Director Claims directs activities within the General and Auto Liability Claims, Physical Damage Repairs and Property and Cargo Claims including the management of loss control activities and third-party provider relationships (including consultants, legal counsel, insurers, and external claims administrators). The Director manages and oversees the physical damage team and handling individual liability, property, and cargo claim. This position reports to the Senior Director of Claims and requires little supervision and is considered a liability, property and physical damage expert within the company. This position has responsibility to handle and manage the aforementioned claims in the US, Canada and Puerto Rico. The Director position leads an internal staff of approximately 40; this consists of professional Claims Managers, Supervisors, Senior Office Manager, Claims Analysts, and clerical staff support. **Essential Functions** + Provides strategic direction to the claims team to establish defined and impacting goals, improve processes, create an inclusive work environment, and motivate staff to reach goals that increase claim quality, costs and improve employee and customer satisfaction. + Ensures consistent identification of exposures, recommends solutions, promotes loss prevention, updates and monitors compliance with procedures and manages documented safety/risk management programs. + Develop and implements processes to ensure physical damage repairs are completed timely and properly partnering with vendor, operations and all business units. + Partners with and gives direction to Operations, Sales, Central Support and Safety in various liability, property and cargo, and physical damage repair matters. + Ensures correct coverage to avoid major exposure while keeping costs at a minimum. + Manages team to ensure the claim process supports proper invoicing and reduce credits to improve customer satisfaction. + Responsible for continuous improvement, developing and implementing new processes to improve overall financial results including the Process Integrity Program. + Significant interaction with field and senior management, internal legal counsel, safety directors, Sales, Ryder Security, and members of corporate risk management. Informs field and senior management on all claims issues. + Primary backup for the Senior Director assisting with all aspects of the operations + Leads and directs claims managers, office manager, and supervisors as well as a team of 40+ claims analysts and administrative staff charging them with continuous development, training sessions, and individual development plans **Additional Responsibilities** + Performs other duties as assigned. + Provides direction on high exposure claims and business process + Routinely updates senior management on trends, compliance issues on specific claims to assist in timely and well-informed business decisions; understand root cause of claim frequency and severity + Establish positive relationships with operations, sales, central support, leadership, and customers. Ensure superior customer service and assist with renewal business + Leads and direct special projects and performs other duties as assigned. **Skills and Abilities** + Demonstrated ability to manage and develop a sizeable staff, Required + Foster collaborative relationships and increase customer satisfaction, Required + Superior ability drives favorable outcomes through strategic negotiations, Required + Demonstrates exceptional interpersonal skills and ability to communicate clearly in verbal and written interactions, Required + Ability to effectively interact and influence Executive, Field management and other business units within Ryder, Required + Create a collaborative environment that drives engagement and results, Required **Qualifications** + Bachelor's degree in business, Economics, Finance or related field or equivalent claims work experience, Required + 10 years or more in in the Casualty Claim field, Required + 5 years or more experience in Vehicle Rental/Leasing Business or Commercial Trucking Insurance, Preferred + 5 years or more in Management or administrative experience, Required + Working knowledge of state laws to include ownership, joint and several liabilities Advanced, Required + Strong understanding of insurance law and policy languages as well as interpreting contracts Advanced, Required + Strong knowledge of the principles of Total Quality Management Advanced, Required + Adjuster Insurance Licenses-Insurance related courses such as I.I.A. or C.P.C.U, Preferred **Job Category:** Risk Management **Compensation Information** : The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. The position may also be eligible to receive an annual bonus, commission, and/or long-term incentive plan based on the level and/or type. Compensation ranges for the position are below: **Pay Type** : Salaried Minimum Pay Range: 150,000 Maximum Pay Range: 200,000 **Benefits Information** : **For all Full-time positions only** : Ryder offers comprehensive health and welfare benefits, to include medical, prescription, dental, vision, life insurance and disability insurance options, as well as paid time off for vacation, illness, bereavement, family and parental leave, and a tax-advantaged 401(k) retirement savings plan. For more information about benefits, click here (********************************************************************************************************** to download the comprehensive benefits summary. Ryder is proud to be an Equal Opportunity Employer and Drug Free workplace. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability. **Important Note** **:** Some positions require additional screening that may include employment and education verification; motor vehicle records check and a road test; and/or badging or background requirements of the customer to which you are assigned. Security Notice for Applicants: Ryder will only communicate with an applicant directly from a [@ryder.com] email address and will never conduct an interview online through a chat type forum, messaging app (such as WhatsApp or Telegram), or via an online questionnaire. During an interview, Ryder will never ask for any form of payment or banking details and will never solicit personal information outside of the formal submitted application through ********************* . Should you have any questions regarding the application process or to verify the legitimacy of an interview or Ryder representative, please contact Ryder at ***************** or ************. **Current Employees** **:** If you are a current employee at Ryder, please click here (*************************************************** to log in to Workday to apply using the internal application process. _Job Seekers can review the Job Applicant Privacy Policy by clicking here (********************************************** ._ \#wd
    $45k-81k yearly est. Easy Apply 60d+ ago
  • Job icon imageJob icon image 2

    Looking for a job?

    Let Zippia find it for you.

  • Senior Marine Claims Specialist-Hull

    Zurich Na 4.8company rating

    Columbus, OH

    130521 We are excited to share that Zurich North America is hiring a Marine Claims Senior Claims Specialist Role (With Hull and Liability experience preferred) to join our team! We are open to remote work for the right candidate located within the U.S.. In this role you will be responsible for: + Ability to handle dedicated accounts. + Frequent interaction with Assureds, Brokers and Underwriters. + Some travel may be required but this is not very frequent. Basic Qualifications: + Bachelor's Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.OR + Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.OR + Zurich Certified Insurance Apprentice, including an associate degree with 6 or more years of experience in the Claims and/ or Litigation Management area.OR + Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.OR + High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.AND + Must obtain and maintain required adjuster license(s) + Microsoft Office experience + Knowledge of insurance regulations, markets, and products as well as maritime and admiralty practices. Preferred Qualifications: + Extensive Marine Hull claims experience preferred. + Emphasis on Marine Liability, Hull, Blue water and brown water claims, Jones Act, General Average and Ocean Cargo Claims experience preferred. + Licensed in all states as needed required. + Effective verbal and written communication skills + Strong analytical, critical thinking and problem-solving skills + Strong multi-tasking and prioritization skills + Experience collaborating in a team environment and building cross functional working relationships + Proactively shares and promotes sharing of insights + Ability to gather unique perspectives from other teams/functions to optimize outcomes. + Understands, analyzes, and applies the component parts of an insurance policy for complex claims + Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims + Ability to determine the scope and exposure for complex claims + Ability to leverage trend and relationships to provide high-quality customer service + Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts. + Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims + Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and merit increases. If your expectations are above the listed range, we still encourage you to apply-your unique background matters to us.The pay range shown is a national average and may vary by location. The proposed Salary range for this position is $75,800.00 - $124,100.00, with short-term incentive bonus eligibility set at 15%. We offer competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here .] **Why Zurich?** At Zurich, we value your ideas and experience. We offer growth, inclusion, and a supportive environment-so you can help shape the future of insurance. Zurich North America is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500 . Join us for a brighter future-for yourself and our customers. Zurich in North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Equal Opportunity Employer disability/vets. Zurich complies with 18 U.S. Code § 1033. **Please note:** Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting Agency Portal. Location(s): AM - Texas Virtual Office, AM - Remote Work (US) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI-ASSOCIATE #LI-REMOTE EOE Disability / Veterans
    $75.8k-124.1k yearly 5d ago
  • Claims Supervisor

    Corvel Enterprise Claims, Inc. 4.7company rating

    Dublin, OH

    Job Description The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a Hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers' Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests Participate in customer claim reviews and presentations Ability to travel overnight and attend meetings if required Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to assist team members to develop knowledge and understanding of claims practice Effective quantitative, analytical and interpretive skills Strong leadership, management and motivational skills Demonstrated, strong customer service skills Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to work both independently and within a team environment Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Demonstrated public speaking skills Minimum of 5 years' claims handling experience Knowledge of WC required Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel Self-Insured Certificate preferred State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71, 696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $71.7k-110.7k yearly 17d ago
  • Casualty Claims Supervisor - AgriBusiness

    Great American Insurance 4.7company rating

    Cincinnati, OH

    Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Running a farm or ranch has always involved a lot of risks. But these days, rapid changes in the industry are raising the stakes. Advanced technologies and new environmental concerns are pushing farming and ranching in new directions. But no matter how much things change, one thing never will: Great American's AgriBusiness Division's commitment to keeping farmers and ranchers strong with effective insurance coverage. The AgriBusiness Division has been helping farmers and ranchers manage the uncertainties of doing business as far back as 1886. Today, the division provides coverage for full-time farms, ranches, and other agricultural operations in 44 states. The farm products can cover businesses that range from fruit and vegetable farms to livestock operations and the equine farm products cover a wide range of risks ranging from monoline property and liability, care custody or control to umbrella and auto. ********************************************************************************************* We are looking for a Claims Supervisor to join our AgriBusiness division in our Cincinnati, OH office. Training will be fully in person, with the opportunity to work a hybrid schedule after training is completed. Essential Job Functions and Responsibilities Coordinates the daily operations of the Claims team, ensuring efficient workflow and productivity. Manages litigation handling. Supervises the investigation of liability claims to confirm coverage and to determine liability, compensability and damages. Reviews and approves appropriate claim settlements/reserves within prescribed authority. Advises team members on handling claim files and extends settlement authority as needed after thorough review. May set reserves and provide recommendations or reports for Corporate Claims or senior management. Responsible for overseeing team priorities and coordinating daily tasks. May occasionally perform tasks alongside direct reports. Operates under policies and procedures with limited oversight. Responsible for performance and coaching of staff and has a participatory role in decisions regarding talent selection, development, and performance management. Performs other duties as assigned. Job Requirements Bachelor's Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience. Generally, a minimum of 5 years of experience in property and casualty claims handling. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC). Coverage and Farm claims experience is a plus. Typically manages 2 or more reports. Provides training to new members of the team. Exhibits exceptional analytical, negotiation, and problem-solving abilities. Ensures the team is knowledgeable of insurance policies, coverage, and claims procedures, and stays updated on industry laws and regulations. Business Unit: AgriBusiness Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.
    $93k-171k yearly est. Auto-Apply 60d+ ago
  • Senior Litigation Adjuster

    CVS Health 4.6company rating

    Delaware, OH

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position SummaryAs a Senior Litigation Adjuster in Risk Management, you will be responsible for managing litigation against CVS and overseeing outside counsel defending CVS in premises lawsuits filed throughout the United States. Responsibilities Include:- Utilizing legal skills and knowledge to oversee and manage complex premises lawsuits against CVS from the initiation of suit through resolution. - Analyzing case files and internal materials and utilizing resources across CVS to investigate and discern key issues in each case. - Developing and implementing a litigation strategy in each case to most efficiently resolve or defend that case. - Assessing the value of all cases through investigation of the pertinent allegations, evaluating the defenses and issues present in each case, and setting appropriate financial reserves. - Reviewing discovery responses, pleadings, motions, etc. drafted by defense counsel. - Providing reporting to key internal stake holders and leadership on case developments. - Developing relationships with internal colleagues for fact-finding and key litigation activities. - Participating in internal meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications- 2+ years of litigation experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. - Ability to travel and participate in legal proceedings, arbitrations, trials, etc. Preferred Qualifications- Experience overseeing or defending premises litigation. - Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. - Experience overseeing and answering written discovery, reviewing pleadings and case filings. - Ability to influence and work collaboratively with senior leaders, CVS's in-house legal counsel and outside defense counsel. - Ability to positively and aggressively represent the company at mediation, arbitration and trial. - Ability to work independently and in an environment requiring teamwork and collaboration. - Ability to navigate difficult situations and communicate effectively with both internal and external groups. - Excellent organizational and time management skills and ability to handle a full docket of litigated claims. - Strong written and verbal communication skills, ability to summarize complex issues in a concise, cogent manner. - Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new claims software programs and systems. Education- Verifiable Bachelor's degree or equivalent work experience required. - JD degree highly desired. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $47k-122.4k yearly 7d ago
  • Insurance Examiner/Analyst Supervisor

    Dasstateoh

    Ohio

    Insurance Examiner/Analyst Supervisor (260000KM) Organization: InsuranceAgency Contact Name and Information: Kim Lowry ************Unposting Date: Jan 31, 2026, 4:59:00 AMWork Location: 50 W Town St 50 West Town Street Suite 300 Columbus 43215Primary Location: United States of America-OHIO-Franklin County Compensation: 77.25Schedule: Full-time Work Hours: 40Classified Indicator: ClassifiedUnion: Exempt from Union Primary Job Skill: AuditingTechnical Skills: Interpreting Financial Statements, Regulatory Compliance, Accounting and Finance, Auditing, InsuranceProfessional Skills: Analyzation, Attention to Detail, Leading Others, Results Oriented, Written Communication Agency Overview About Us:The Ohio Department of Insurance (ODI) was established in 1872 as an agency charged with overseeing insurance regulations, enforcing statutes mandating consumer protections, educating consumers, and fostering the stability of insurance markets in Ohio.Today, the mission of the Ohio Department of Insurance is to provide consumer protection through education and fair but vigilant regulation while promoting a stable and competitive environment for insurers.Please visit our website Department of Insurance and also find us on LinkedIn.Job DutiesThis position is only open to current Ohio Department of Insurance employees.The Office of Risk Assessment is seeking a highly motivated and experienced accounting/financial professional to manage a staff of Insurance examiner/analysts. The individual will have excellent communication, problem solving, and organizational skills.If this sounds interesting to you, continue reading below to learn more about this career opportunity with the Office of Risk Assessment.Your Key Responsibilities include but are not limited to the following:Supervises team of insurance examiner/analysts in conducting in-house analysis of insurance companies (e.g., life, property & casualty, health insuring corporations, multiple employer welfare arrangements, title, fraternal benefit societies & mutual protective associations) licensed to do business in Ohio.Schedules meetings with insurers (e.g., to discuss business plans, mergers, acquisitions, types of business written, material reinsurance contracts, & investment policies).Reviews & evaluates insurance companies' documents (e.g., statutory financial statements; CPA audited financial statements; management & service agreements; actuarial opinions; holding company filings; statutory reports of examinations; complaint activity.Prepares & conducts performance evaluations, initiates disciplinary actions, recommends &/or provides training, approves or disapproves requests for leave, & travel expense reports.Conducts periodic staff meetings; assists in regulatory actions against insurers (e.g., supervisions, rehabilitation, & liquidations); prepares work papers &/or writes reports to document findings during limited-scope or target examinations.Reviews examination/analysis projects of examiner/analysts, determines analysis emphasis & establishes time-budgets & upon completion, reviews prepared files (e.g., permanent files, surveillance files, planning & administration files) to control consistency & quality, assesses progress of examination/analysis work to assure proper procedures are performed & documented (e.g., correct conclusions drawn, final reports accurate, concise & completed within established time budgets).Coordinates work & assesses progress, oversees issuance of periodic & special reports & develops, implements, & maintains procedure manuals & writes reports of examination, stating findings of material changes &/or issues of regulatory significance.Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsCertified Public Accountant (i.e., CPA) designation by state accountancy board; 5 yrs. exp. in accounting, marketing, internal auditing, finance, insurance or business administration; valid driver's license; must provide own transportation. -Or Certified Financial Examiner (i.e., CFE) designation by Society of Financial Examiners; 5 yrs. exp. in accounting, internal auditing, finance, marketing, insurance or business administration; valid driver's license; must provide own transportation. -Or equivalent of Minimum Class Qualifications For Employment noted above may be substituted for the experience required, but not for the mandated licensure/designation. Job Skills: AuditingSupplemental InformationApplication Procedures:When completing the different sections of this application, be sure to clearly describe how you meet the minimum qualifications outlined in this job posting. We cannot give you credit for your Work Experience and Education & Certifications if you do not provide that information in your online application. Information in attached resumes or cover letters must be entered into your application in the appropriate Work Experience or Education & Certification sections to be considered.Status of Posted Positions:You can check the status of your application online by signing into your profile. Jobs you applied for will be listed. The application status is shown to the right of the position title and application submission details. Questions about the position not pertaining to your application status can be directed to: Kim Lowry @ ************. Applicants must be currently authorized to work in the United States on a full-time basis.Reasonable Accommodation:ODI does not discriminate on the basis of disability in its hiring or employment practices and complies with the ADA employment regulations. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact the agency Human Resource Offices' ADA Coordinator, Andrew Skal, by emailing ****************************** or calling ************. Otherwise, you will be given specific instructions on requesting an accommodation if you are invited to participate in a structured interview.Background Check Information:The final candidate selected for this position will be required to undergo a criminal background check. Section 2961 of the Ohio Revised Code (ORC) prohibits individuals convicted of a felony involving fraud, deceit or theft from holding a position that has substantial management of control over property of a state agency.ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
    $42k-66k yearly est. Auto-Apply 8h ago
  • Director Claims

    Ryder System Inc. 4.4company rating

    Columbus, OH

    The Director Claims directs activities within the General and Auto Liability Claims, Physical Damage Repairs and Property and Cargo Claims including the management of loss control activities and third-party provider relationships (including consultants, legal counsel, insurers, and external claims administrators). The Director manages and oversees the physical damage team and handling individual liability, property, and cargo claim. This position reports to the Senior Director of Claims and requires little supervision and is considered a liability, property and physical damage expert within the company. This position has responsibility to handle and manage the aforementioned claims in the US, Canada and Puerto Rico. The Director position leads an internal staff of approximately 40; this consists of professional Claims Managers, Supervisors, Senior Office Manager, Claims Analysts, and clerical staff support. Essential Functions + Provides strategic direction to the claims team to establish defined and impacting goals, improve processes, create an inclusive work environment, and motivate staff to reach goals that increase claim quality, costs and improve employee and customer satisfaction. + Ensures consistent identification of exposures, recommends solutions, promotes loss prevention, updates and monitors compliance with procedures and manages documented safety/risk management programs. + Develop and implements processes to ensure physical damage repairs are completed timely and properly partnering with vendor, operations and all business units. + Partners with and gives direction to Operations, Sales, Central Support and Safety in various liability, property and cargo, and physical damage repair matters. + Ensures correct coverage to avoid major exposure while keeping costs at a minimum. + Manages team to ensure the claim process supports proper invoicing and reduce credits to improve customer satisfaction. + Responsible for continuous improvement, developing and implementing new processes to improve overall financial results including the Process Integrity Program. + Significant interaction with field and senior management, internal legal counsel, safety directors, Sales, Ryder Security, and members of corporate risk management. Informs field and senior management on all claims issues. + Primary backup for the Senior Director assisting with all aspects of the operations + Leads and directs claims managers, office manager, and supervisors as well as a team of 40+ claims analysts and administrative staff charging them with continuous development, training sessions, and individual development plans Additional Responsibilities + Performs other duties as assigned. + Provides direction on high exposure claims and business process + Routinely updates senior management on trends, compliance issues on specific claims to assist in timely and well-informed business decisions; understand root cause of claim frequency and severity + Establish positive relationships with operations, sales, central support, leadership, and customers. Ensure superior customer service and assist with renewal business + Leads and direct special projects and performs other duties as assigned. Skills and Abilities + Demonstrated ability to manage and develop a sizeable staff, Required + Foster collaborative relationships and increase customer satisfaction, Required + Superior ability drives favorable outcomes through strategic negotiations, Required + Demonstrates exceptional interpersonal skills and ability to communicate clearly in verbal and written interactions, Required + Ability to effectively interact and influence Executive, Field management and other business units within Ryder, Required + Create a collaborative environment that drives engagement and results, Required Qualifications + Bachelor's degree in business, Economics, Finance or related field or equivalent claims work experience, Required + 10 years or more in in the Casualty Claim field, Required + 5 years or more experience in Vehicle Rental/Leasing Business or Commercial Trucking Insurance, Preferred + 5 years or more in Management or administrative experience, Required + Working knowledge of state laws to include ownership, joint and several liabilities Advanced, Required + Strong understanding of insurance law and policy languages as well as interpreting contracts Advanced, Required + Strong knowledge of the principles of Total Quality Management Advanced, Required + Adjuster Insurance Licenses-Insurance related courses such as I.I.A. or C.P.C.U, Preferred Job Category: Risk Management Compensation Information : The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. The position may also be eligible to receive an annual bonus, commission, and/or long-term incentive plan based on the level and/or type. Compensation ranges for the position are below: Pay Type : Salaried Minimum Pay Range: 150,000 Maximum Pay Range: 200,000 Benefits Information : For all Full-time positions only : Ryder offers comprehensive health and welfare benefits, to include medical, prescription, dental, vision, life insurance and disability insurance options, as well as paid time off for vacation, illness, bereavement, family and parental leave, and a tax-advantaged 401(k) retirement savings plan. For more information about benefits, click here (********************************************************************************************************** to download the comprehensive benefits summary. Ryder is proud to be an Equal Opportunity Employer and Drug Free workplace. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability. Important Note : Some positions require additional screening that may include employment and education verification; motor vehicle records check and a road test; and/or badging or background requirements of the customer to which you are assigned. Security Notice for Applicants: Ryder will only communicate with an applicant directly from a [@ryder.com] email address and will never conduct an interview online through a chat type forum, messaging app (such as WhatsApp or Telegram), or via an online questionnaire. During an interview, Ryder will never ask for any form of payment or banking details and will never solicit personal information outside of the formal submitted application through ********************* . Should you have any questions regarding the application process or to verify the legitimacy of an interview or Ryder representative, please contact Ryder at ***************** or ************. Current Employees : If you are a current employee at Ryder, please click here (*************************************************** to log in to Workday to apply using the internal application process. _Job Seekers can review the Job Applicant Privacy Policy by clicking here (********************************************** ._ \#wd
    $45k-81k yearly est. Auto-Apply 41d ago
  • Claims Supervisor

    Corvel 4.7company rating

    Dublin, OH

    The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a Hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Supervises claims staff in their day-to-day operations * Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions * Ensures staff compliance with Workers' Compensation laws and mandated regulatory reporting requirements * Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) * Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions * Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests * Participate in customer claim reviews and presentations * Ability to travel overnight and attend meetings if required * Additional duties as assigned KNOWLEDGE & SKILLS: * Excellent written and verbal communication skills * Ability to assist team members to develop knowledge and understanding of claims practice * Effective quantitative, analytical and interpretive skills * Strong leadership, management and motivational skills * Demonstrated, strong customer service skills * Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence * Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets * Strong interpersonal, time management and organizational skills * Ability to work both independently and within a team environment * Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation EDUCATION & EXPERIENCE: * Bachelor's degree or a combination of education and related experience * Demonstrated public speaking skills * Minimum of 5 years' claims handling experience * Knowledge of WC required * Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel * Self-Insured Certificate preferred * State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71, 696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $71.7k-110.7k yearly 60d+ ago
  • Senior Litigation Adjuster

    CVS Health 4.6company rating

    Ohio

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position SummaryAs a Senior Litigation Adjuster in Risk Management, you will be responsible for managing litigation against CVS and overseeing outside counsel defending CVS in premises lawsuits filed throughout the United States. Responsibilities Include:- Utilizing legal skills and knowledge to oversee and manage complex premises lawsuits against CVS from the initiation of suit through resolution. - Analyzing case files and internal materials and utilizing resources across CVS to investigate and discern key issues in each case. - Developing and implementing a litigation strategy in each case to most efficiently resolve or defend that case. - Assessing the value of all cases through investigation of the pertinent allegations, evaluating the defenses and issues present in each case, and setting appropriate financial reserves. - Reviewing discovery responses, pleadings, motions, etc. drafted by defense counsel. - Providing reporting to key internal stake holders and leadership on case developments. - Developing relationships with internal colleagues for fact-finding and key litigation activities. - Participating in internal meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications- 2+ years of litigation experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. - Ability to travel and participate in legal proceedings, arbitrations, trials, etc. Preferred Qualifications- Experience overseeing or defending premises litigation. - Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. - Experience overseeing and answering written discovery, reviewing pleadings and case filings. - Ability to influence and work collaboratively with senior leaders, CVS's in-house legal counsel and outside defense counsel. - Ability to positively and aggressively represent the company at mediation, arbitration and trial. - Ability to work independently and in an environment requiring teamwork and collaboration. - Ability to navigate difficult situations and communicate effectively with both internal and external groups. - Excellent organizational and time management skills and ability to handle a full docket of litigated claims. - Strong written and verbal communication skills, ability to summarize complex issues in a concise, cogent manner. - Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new claims software programs and systems. Education- Verifiable Bachelor's degree or equivalent work experience required. - JD degree highly desired. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $47k-122.4k yearly 7d ago
  • Senior Claims Specialist - CA Workers' Compensation

    Great American Insurance Group (DBA 4.7company rating

    Oregon, OH

    Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. * -------------------------------------------- When is the last time you felt like you made a difference to your employer and in the job you do? Been awhile? Never? Our employees at Strategic Comp DO make a difference and feel appreciated for it. In fact, we received 98% rating for overall job satisfaction from the participants in our last employee survey, clearly indicating the passion and energy our staff has for our company and for the job they do! Currently we have an opening for a Senior Claims Specialist in your territory. Are you innovative, high energy, resilient, determined, assertive, clever, and competitive? Do you see each new claim as a puzzle to work and a challenge to be won? Does this sound like you? If so, this might be the right job for you. Here's who we are. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses. The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG's common stock is listed and traded on the New York Stock Exchange ("NYSE") and NASDAQ under the symbol "AFG". Here's what we do. We insure workers' compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We've found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning they enjoy working with us too! Here's what you would be doing if hired for the Senior Claims Specialist position. Your role would be to investigate and adjust workers' compensation claims with high potential exposure. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use. Because we focus on outcomes and not just processes, we look for the adjuster who is very skilled at developing strategies to bring claims to resolution. The person hired for this position will work from an office in their home within the Pacific Region with occasional travel to claims reviews and meetings. Responsibilities * Investigating losses * Analyzing coverage, determining compensability and benefits * Establishing reserves and negotiating settlements * Conducting meetings on the phone with insureds and claimants * Preparing large loss reports to both internal and external audiences * Attending settlement conferences as assigned * Working closely with defense attorneys and other vendors including medical case management, surveillance, etc. Physical Requirements * Sedentary - requires prolonged sitting, continuous use of computer * Occasional Travel - may require overnight travel to tri-annual claim reviews and/or departmental meetings Qualifications * A minimum of 10 to 13 years of California workers' compensation claims adjusting experience with higher exposure claims is required * Must have current license to adjust workers' compensation claims in California * Strong consideration will be given to candidates with industry designations including Associate in Claims * You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts #LI-StrategicComp Business Unit: Strategic Comp Salary Range: $110,000.00 -$120,000.00 Benefits: We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at **************************** * Excludes seasonal employees and interns.
    $110k-120k yearly Auto-Apply 32d ago
  • Claims Supervisor

    Corvel Career Site 4.7company rating

    Dublin, OH

    The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a Hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers' Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests Participate in customer claim reviews and presentations Ability to travel overnight and attend meetings if required Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to assist team members to develop knowledge and understanding of claims practice Effective quantitative, analytical and interpretive skills Strong leadership, management and motivational skills Demonstrated, strong customer service skills Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to work both independently and within a team environment Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Demonstrated public speaking skills Minimum of 5 years' claims handling experience Knowledge of WC required Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel Self-Insured Certificate preferred State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71, 696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $71.7k-110.7k yearly 60d+ ago
  • Senior Claims Specialist - OR & CA Workers' Compensation

    Great American Insurance Group (DBA 4.7company rating

    Oregon, OH

    Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. * -------------------------------------------- When is the last time you felt like you made a difference to your employer and in the job you do? Been awhile? Never? Our employees at Strategic Comp DO make a difference and feel appreciated for it. In fact, we received 98% rating for overall job satisfaction from the participants in our last employee survey, clearly indicating the passion and energy our staff has for our company and for the job they do! Currently we have an opening for a Senior Claims Specialist in your territory. Are you innovative, high energy, resilient, determined, assertive, clever, and competitive? Do you see each new claim as a puzzle to work and a challenge to be won? Does this sound like you? If so, this might be the right job for you. Here's who we are. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses. The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG's common stock is listed and traded on the New York Stock Exchange ("NYSE") and NASDAQ under the symbol "AFG". Here's what we do. We insure workers' compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We've found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning they enjoy working with us too! Here's what you would be doing if hired for the Senior Claims Specialist position. Your role would be to investigate and adjust workers' compensation claims with high potential exposure. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use. Because we focus on outcomes and not just processes, we look for the adjuster who is very skilled at developing strategies to bring claims to resolution. The person hired for this position will work from an office in their home in Oregon with occasional travel to claims reviews and meetings. Responsibilities * Investigating losses * Analyzing coverage, determining compensability and benefits * Establishing reserves and negotiating settlements * Conducting meetings on the phone with insureds and claimants * Preparing large loss reports to both internal and external audiences * Attending settlement conferences as assigned * Working closely with defense attorneys and other vendors including medical case management, surveillance, etc. Physical Requirements * Sedentary - requires prolonged sitting, continuous use of computer * Occasional Travel - may require overnight travel to tri-annual claim reviews and/or departmental meetings Qualifications * A minimum of 10 to 13 years of Oregon and California workers' compensation claims adjusting experience with higher exposure claims is required * Must have current license to adjust workers' compensation claims in California * Strong consideration will be given to candidates with industry designations including Associate in Claims * You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts #LI-StrategicComp Business Unit: Strategic Comp Salary Range: $105,000.00 -$115,000.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.
    $105k-115k yearly Auto-Apply 57d ago
  • Senior Litigation Adjuster

    CVS Health 4.6company rating

    Oregon, OH

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position SummaryAs a Senior Litigation Adjuster in Risk Management, you will be responsible for managing litigation against CVS and overseeing outside counsel defending CVS in premises lawsuits filed throughout the United States. Responsibilities Include:- Utilizing legal skills and knowledge to oversee and manage complex premises lawsuits against CVS from the initiation of suit through resolution. - Analyzing case files and internal materials and utilizing resources across CVS to investigate and discern key issues in each case. - Developing and implementing a litigation strategy in each case to most efficiently resolve or defend that case. - Assessing the value of all cases through investigation of the pertinent allegations, evaluating the defenses and issues present in each case, and setting appropriate financial reserves. - Reviewing discovery responses, pleadings, motions, etc. drafted by defense counsel. - Providing reporting to key internal stake holders and leadership on case developments. - Developing relationships with internal colleagues for fact-finding and key litigation activities. - Participating in internal meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications- 2+ years of litigation experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. - Ability to travel and participate in legal proceedings, arbitrations, trials, etc. Preferred Qualifications- Experience overseeing or defending premises litigation. - Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. - Experience overseeing and answering written discovery, reviewing pleadings and case filings. - Ability to influence and work collaboratively with senior leaders, CVS's in-house legal counsel and outside defense counsel. - Ability to positively and aggressively represent the company at mediation, arbitration and trial. - Ability to work independently and in an environment requiring teamwork and collaboration. - Ability to navigate difficult situations and communicate effectively with both internal and external groups. - Excellent organizational and time management skills and ability to handle a full docket of litigated claims. - Strong written and verbal communication skills, ability to summarize complex issues in a concise, cogent manner. - Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new claims software programs and systems. Education- Verifiable Bachelor's degree or equivalent work experience required. - JD degree highly desired. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $47k-122.4k yearly 7d ago
  • Senior Litigation Adjuster

    CVS Health 4.6company rating

    New Hampshire, OH

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position SummaryAs a Senior Litigation Adjuster in Risk Management, you will be responsible for managing litigation against CVS and overseeing outside counsel defending CVS in premises lawsuits filed throughout the United States. Responsibilities Include:- Utilizing legal skills and knowledge to oversee and manage complex premises lawsuits against CVS from the initiation of suit through resolution. - Analyzing case files and internal materials and utilizing resources across CVS to investigate and discern key issues in each case. - Developing and implementing a litigation strategy in each case to most efficiently resolve or defend that case. - Assessing the value of all cases through investigation of the pertinent allegations, evaluating the defenses and issues present in each case, and setting appropriate financial reserves. - Reviewing discovery responses, pleadings, motions, etc. drafted by defense counsel. - Providing reporting to key internal stake holders and leadership on case developments. - Developing relationships with internal colleagues for fact-finding and key litigation activities. - Participating in internal meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications- 2+ years of litigation experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. - Ability to travel and participate in legal proceedings, arbitrations, trials, etc. Preferred Qualifications- Experience overseeing or defending premises litigation. - Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. - Experience overseeing and answering written discovery, reviewing pleadings and case filings. - Ability to influence and work collaboratively with senior leaders, CVS's in-house legal counsel and outside defense counsel. - Ability to positively and aggressively represent the company at mediation, arbitration and trial. - Ability to work independently and in an environment requiring teamwork and collaboration. - Ability to navigate difficult situations and communicate effectively with both internal and external groups. - Excellent organizational and time management skills and ability to handle a full docket of litigated claims. - Strong written and verbal communication skills, ability to summarize complex issues in a concise, cogent manner. - Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new claims software programs and systems. Education- Verifiable Bachelor's degree or equivalent work experience required. - JD degree highly desired. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $47k-122.4k yearly 7d ago
  • Senior Litigation Adjuster

    CVS Health 4.6company rating

    Homeworth, OH

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. **Position Summary** As a Senior Litigation Adjuster in Risk Management, you will be responsible for managing litigation against CVS and overseeing outside counsel defending CVS in premises lawsuits filed throughout the United States. Responsibilities Include: - Utilizing legal skills and knowledge to oversee and manage complex premises lawsuits against CVS from the initiation of suit through resolution. - Analyzing case files and internal materials and utilizing resources across CVS to investigate and discern key issues in each case. - Developing and implementing a litigation strategy in each case to most efficiently resolve or defend that case. - Assessing the value of all cases through investigation of the pertinent allegations, evaluating the defenses and issues present in each case, and setting appropriate financial reserves. - Reviewing discovery responses, pleadings, motions, etc. drafted by defense counsel. - Providing reporting to key internal stake holders and leadership on case developments. - Developing relationships with internal colleagues for fact-finding and key litigation activities. - Participating in internal meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. **Required Qualifications** - 2+ years of litigation experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. - Ability to travel and participate in legal proceedings, arbitrations, trials, etc. **Preferred Qualifications** - Experience overseeing or defending premises litigation. - Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. - Experience overseeing and answering written discovery, reviewing pleadings and case filings. - Ability to influence and work collaboratively with senior leaders, CVS's in-house legal counsel and outside defense counsel. - Ability to positively and aggressively represent the company at mediation, arbitration and trial. - Ability to work independently and in an environment requiring teamwork and collaboration. - Ability to navigate difficult situations and communicate effectively with both internal and external groups. - Excellent organizational and time management skills and ability to handle a full docket of litigated claims. - Strong written and verbal communication skills, ability to summarize complex issues in a concise, cogent manner. - Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new claims software programs and systems. **Education** - Verifiable Bachelor's degree or equivalent work experience required. - JD degree highly desired. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/28/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.
    $47k-122.4k yearly 7d ago
  • Senior Claim Benefit Specialist

    CVS Health 4.6company rating

    Delaware, OH

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryReviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. Additional Responsibilities: Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists. - Makes outbound calls to obtain required information for claim or reconsideration. Required Qualifications- New York Independent Adjuster License- Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Preferred Qualifications- 18+ months of medical claim processing experience- Self-Funding experience- DG system knowledge Education- High School Diploma required- Preferred Associates degree or equivalent work experience. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/27/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $18 hourly 19d ago
  • Senior Claim Benefit Specialist

    CVS Health 4.6company rating

    Ohio

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryReviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. Additional Responsibilities: Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists. - Makes outbound calls to obtain required information for claim or reconsideration. Required Qualifications- New York Independent Adjuster License- Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Preferred Qualifications- 18+ months of medical claim processing experience- Self-Funding experience- DG system knowledge Education- High School Diploma required- Preferred Associates degree or equivalent work experience. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/27/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $18 hourly 19d ago
  • Claim Benefit Specialist

    CVS Health 4.6company rating

    Ohio

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. A Brief OverviewPerforms claim documentation review, verifies policy coverage, assesses claim validity, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. What you will do Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims. Determines if claims processing activities comply with regulatory requirements, industry standards, and company policies. Develops and implements regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development. Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Required Qualifications1-2 years' experience working in Customer Service. Possess strong teamwork and organizational skills. Strong and effective communication skills. Ability to handle multiple assignments competently through use of time management, accurately and efficiently. Strong proficiency using computers and experience with data entry. Preferred QualificationsExperience in a production environment. Healthcare experience. Knowledge of utilizing multiple systems at once to resolve complex issues. Claim processing experience preferred but not required. Understanding of medical terminology. EducationHigh School or GED equivalent. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$17. 00 - $28. 46This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $17 hourly 1d ago
  • Senior Claim Benefit Specialist

    CVS Health 4.6company rating

    Homeworth, OH

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for claim or reconsideration. **Required Qualifications** - New York Independent Adjuster License - Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system knowledge **Education** **-** High School Diploma required - Preferred Associates degree or equivalent work experience. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.
    $18.5-42.4 hourly 14d ago
  • Senior Claim Benefit Specialist

    CVS Health 4.6company rating

    Oregon, OH

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryReviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. Additional Responsibilities: Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists. - Makes outbound calls to obtain required information for claim or reconsideration. Required Qualifications- New York Independent Adjuster License- Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Preferred Qualifications- 18+ months of medical claim processing experience- Self-Funding experience- DG system knowledge Education- High School Diploma required- Preferred Associates degree or equivalent work experience. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/27/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $18 hourly 19d ago

Learn more about claims director jobs