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  • Insurance Claims Specialist

    Marubeni America Corporation 4.6company rating

    Claims representative job in New York, NY

    To be considered, please apply through the link here. We are seeking an experienced and independent Insurance Claims Specialist with 7+ years of multi-line claims experience to manage and resolve claims across Marine Cargo, Property & Casualty, Automobile, Workers' Compensation, and Liability/Litigation. The role also supports contract reviews by assessing insurance-related provisions to ensure alignment with policy coverage and claims protocols. The ideal candidate will also provide support to the Insurance Manager and General Manager on special insurance projects as needed, contributing to broader departmental goals and demonstrating flexibility beyond core claims duties. ESSENTIAL JOB DUTIES: Manage the end-to-end claims process for: -Marine cargo/inland transit -Commercial property and general liability -Automobile (fleet and HNOA) -Workers' Compensation (“WC”) -Litigated liability claims, including bodily injury and third-party property damage Handle end-to-end claims for marine, property, liability, auto (fleet/HNOA), WC, and litigated matters including bodily injury and third-party property damage. Review policies to assess coverage, exclusions, deductibles, and retentions Coordinate with brokers, carriers, adjusters, and Internal legal counsel Support contract review by evaluating insurance clauses (limits, AI, Waiver of Subrogation) and identifying potential risk/coverage gaps Draft claim notifications and ensure compliance with policy timelines Provide loss history, reserve, and claim summaries to assist with renewal preparation Collaborate with Legal, MGC, and MAC BU Operations to resolve claims Participate in claim reviews and strategic discussions in recovery efforts Support the GM and Insurance Manager with special insurance-related projects as needed, and demonstrate flexibility in cross-functional assignments. MINIMUM EDUCATION REQUIREMENTS: Bachelor's degree in insurance or business-related fields or equivalent experience. MINIMUM EXPERIENCE AND CAPABILITY REQUIREMENTS: 7+ years of insurance claims experience across multiple P&C lines, including marine and litigated claims. Strong working knowledge of insurance policy language, ISO forms, and manuscript policies. Familiarity with contractual risk transfer principles and ability to analyze insurance-related clauses. Experience coordinating with external counsel and adjusters on complex/litigated claims. Proficiency in claims systems, Microsoft Word and Excel, and document management platforms. Technically skilled in both claims handling and policy interpretation. Detail-oriented with excellent judgment and risk awareness. Confident in reviewing contract language from an insurance perspective. Collaborative and able to communicate effectively with both technical and non-technical stakeholders. Able to manage competing priorities and operate independently. Must have the ability to work with deadlines and work in a fast-paced and dynamic work environment. Requires excellent written and verbal communication skills. Must be able to work in a multi-cultural business environment. JOB-RELATED CERTIFICATION: CPCU, ARM, or AIC designation preferred
    $46k-71k yearly est. 2d ago
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  • Claims Representative, PIP Litigation (Independent Agent)

    Plymouth Rock Assurance 4.7company rating

    Claims representative job in Woodbridge, NJ

    In this vital role, the Medical Claims Litigation Representative is responsible for the management of arbitrations and lawsuits resulting from the processing of Personal Injury Protection and Extended Medical Expense Claims. These cases are handled in accordance to state compliance requirements and guidelines. RESPONSIBILITIES The ideal candidate for this position must have functional knowledge of medical terminology and anatomy with a thorough understanding of NJ Personal Injury and Protection claim handling regulatory requirements as well as a functional knowledge of the NJ Arbitration and Court Systems. Must be able to investigate, perform analysis and negotiate Personal Injury related settlements with attorneys. Ability to identify litigation trends and suggest alternative defenses. The candidate must have the ability to outline mitigating points to prepare cases for a defense and manage the litigation process with both House Counsel and Outside Counsel. Ability to participate in and organize settlement conferences and projects utilizing the our internal data sources and Microsoft Excel. Excellent verbal and written communication skills are essential. Strong organizational, computer and interpersonal skills are required. The selected candidate must be able to manage multiple tasks including time sensitive issues. QUALIFICATIONS A Bachelor's Degree (B.A.) from a four year college or university; or three (3) to four (4) years related experience and/or training; or an equivalent combination of education and experience. Proficient working knowledge of Microsoft Office suite products. Familiarity with Tableau is a plus. SALARY RANGE The pay range for this position is $55,000 to $75,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. PERKS & BENEFITS 4 weeks accrued paid time off, 2 floating holidays, and 8 paid national holidays per year Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision) Annual 401(k) Employer Contribution Resources to promote Professional Development (LinkedIn Learning and licensure assistance) Robust health and wellness program and fitness reimbursements Various Paid Family leave options including Paid Parental Leave Tuition Reimbursement ABOUT THE COMPANY The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”. #LI-DNI
    $55k-75k yearly 1d ago
  • Claims Court Representative (Court Liaison)

    Greater New York Mutual Insurance Company 4.3company rating

    Claims representative job in New York, NY

    An Insurance Claims Court Representative role involves overseeing litigated claims, analyzing legal/medical data, collaborating with claims and trial lawyers, requiring strong analytical, negotiation, and communication skills to resolve high-stakes cases efficiently for optimal outcomes and cost control, often involving court appearances including conferences, mediations, and trials. Position requires the candidate to be the face of GNY in the NYC, Long Island and Westchester courts, working closely with defense counsel. Essential Duties and Responsibilities: Monitoring the legal defense of claims and coordinating with claims examiners and claims management. Reviewing claims files, reviewing medical records/police reports, evaluating policy coverage, and assessing damages. Working with defense attorneys. Analyzing claim data for trends, providing status reports to management, and ensuring accurate record-keeping. Negotiating settlements and presenting cases at claim committee meetings or mediations. Occasionally making settlement calls. Document file notes in ImageRight. Participates in special projects and performs additional duties as required. Qualifications Education and Experience: Bachelors degree required; J.D. would be a plus. Minimum of 5 years' related experience. Strong analytical, negotiation, and communication (written/verbal) skills. Highly skilled in trial preparation. Proficiency with claims management software, databases, and MS Office. Understanding of relevant insurance laws and regulations. Experience in claims adjusting. Good knowledge of the law, settlement values, judges, adversaries, defense firms, venues. Knowledge of New York State Insurance Department regulations including fair claim standards. Other Requirements: Ability to travel back and forth between office and court. The salary range for this role is $74,600 - $136,100. The listed annual salary range posted for this position is subject to change and may vary depending on performance, education, experience, skills, geographic location, travel requirements, demonstrated proficiency in the competencies required for the role and business needs. Base pay is just one component of GNY's total compensation package for employees. Other rewards include eligibility for an annual discretionary bonus based on performance.
    $39k-54k yearly est. 12d ago
  • Trucking Claims Specialist

    Guard Insurance Group

    Claims representative job in New York, NY

    Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service. Key Responsibilities * Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures. * Review and interpret policy language to determine coverage and consult with coverage counsel when needed. * Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies. * Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information. * Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts. * Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards. * Participate in file reviews, team meetings, and ongoing training to support continuous learning. Salary Range $95,000.00-$145,000.00 USD The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Qualifications * Minimum of 3 years of trucking industry experience. * Experience with bodily injury and/or cargo exposures. * Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices. * Strong analytical and negotiation skills, with the ability to manage multiple priorities. * Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism. * Possession of applicable state adjuster licenses. * Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
    $95k-145k yearly Auto-Apply 60d+ ago
  • Technical Claims Specialist, WC

    Liberty Mutual 4.5company rating

    Claims representative job in Marlton, NJ

    This is a complex claims role responsible for end-to-end handling of small commercial Workers' Compensation claims, including high-severity and litigated matters. The position primarily supports CT, MA, NJ, PA, and RI and requires strong technical expertise and multi-jurisdiction experience. Key Responsibilities: * Investigate, evaluate, and resolve complex and litigated WC claims with accuracy and timeliness * Set and manage reserves; develop resolution strategies; negotiate settlements * Partner with defense counsel and vendors; manage litigation plans and outcomes * Ensure compliance with state statutes, regulations, and internal guidelines * Communicate effectively with insureds, brokers, medical providers, and internal stakeholders Strong Preference: * Required: Prior Workers' Compensation claims experience, including complex and litigated case handling * Proven negotiation, litigation management, and analytical skills * Excellent communication, organization, and decision-making abilities * May require state-specific claims adjuster licensing; candidates must hold (or be able to obtain and maintain) all necessary licenses for CT, MA, NJ, PA, and RI. Remote role. If you live within 50 miles of a USRM hub location, in-office presence is required twice per month. Qualifications * A Bachelors degree or equivalent business experience is required * In addition, the candidate will generally posses 5-7 years of related claims experience with 1-2 years of experience in complex claims * Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skill required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco
    $86k-117k yearly est. Auto-Apply 5d ago
  • No-Fault Claims Adjuster

    Abrams Fensterman 3.3company rating

    Claims representative job in New York, NY

    Job DescriptionSalary: $55k-$65k No-Fault Claims Adjuster Our legal team is committed to providing each client with quality counsel, innovative solutions, and personalized service. Founded in 2000, the firm offers the legal expertise of its 115+ attorneys, who have accumulated experience and problem-solving skills over decades of practice. We are a vibrant, busy, and growing full-service law firm looking to increase its talented ranks of support staff by adding a No-Fault Claims Adjuster with a demonstrated interest and experience of 2-3 years working on no-fault claims in the state of New York. Successful Candidate The successful candidate must have an understanding and experience of Regulation 68 with an emphasis on regulatory time frames. Understanding of New York, No-Fault Arbitration, and the No-Fault Claims process. Must be a true team player genuinely interested in working in a supportive, collaborative team environment. The candidate must be proficient in inputting and identifying information that pertains to new claims in a timely and accurate manner. The duties of the candidate will include working with insurance companies directly to process data entry of claims, medical records, and vendor bills, process insurance claims, and refund/claim checks, and perform daily administrative functions such as answering the phone photocopying, filing, and scanning. What you'll need to have: Expertise with the ADR providers online dispute resolution platform Ability to understand medical reports and medical terminology Ability to understand legal concepts and legal terminology Understanding of worker compensation fee schedule Exceptional organizational skills Demonstrate ability to work under tight deadlines Demonstrate ability to adapt to new and changing business needs Adjuster License a PLUS Additional Information: Salary Range: $55k-$65k Benefits: Medical, Dental, 401K, PTO & Life Insurance Location: On-site in Brooklyn
    $55k-65k yearly 6d ago
  • Multi-Line Adjuster Trainee

    Geico Insurance 4.1company rating

    Claims representative job in New York, NY

    At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Multi-line Adjuster Trainee -New York City, NY, Buffalo, NY, Syracuse, NY Rochester, NY, Albany, NY Salary: "*Starting pay rate varies based upon position and location. Ask your Recruiter for details!" We are looking for a highly motivated and service-oriented individual to join our Multi-line Damage team as a Multi-line Property Damage Trainee! As an ambassador for GEICO's renowned customer service, you will work in a dynamic environment that may include repair shops, salvage yards, a customer's home or in a virtual estimating environment. You will be responsible for inspecting damage, estimating cost of repairs, negotiating settlements, issuing payments, and providing excellent customer service. This position primarily will include servicing boat, motorcycle, RV and other specialty claims. Our industry-leading, paid training, which includes 3-weeks of required hands-on experience at our Ashburn, VA training facility will teach you the ins and outs of physical damage adjusting. We will provide the resources and training so you can directly assist our customers after accidents or major disasters. We're looking for those who are equally as motivated as they are compassionate. Your unique skillset, along with the latest adjusting tools and tech, will help you. Qualifications & Skills: Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits Willingness to be flexible with primary work location - position may require either remote or field work Solid computer, mechanical aptitude, and multi-tasking skills Effective attention to detail and decision-making skills Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities Minimum of high school diploma or equivalent, college degree or currently pursuing preferred Annual Salary $25.44 - $45.28 The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations. At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. * Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. * Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. * Access to additional benefits like mental healthcare as well as fertility and adoption assistance. * Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
    $25.4-45.3 hourly Auto-Apply 14d ago
  • PIP Appeal and Litigation Adjuster

    NJM Insurance Group 4.7company rating

    Claims representative job in Hammonton, NJ

    NJM's General Claims Legal department is seeking a PIP Appeal and Litigation (PAL) Adjuster who will be responsible for conducting a complete and thorough investigation on assigned claims and manage those claims through their life cycle. Job Responsibilities: Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures. Review, manage and update litigated files to maximize litigation resources and ensure legal outcomes consistent with NJM litigation strategy. Evaluate and process all claims, settlements and awards consistent with the proper regulatory, statutory and NJM guidelines for the governing time periods. Communicate timely and effectively with defense counsel in preparing for trial/arbitration and attend legal proceedings as appropriate. Collaborate and communicate cross-departmentally regarding claims and appeals handling related to pending litigation. Required Skills & Qualifications: Minimum 3 years' experience working in a previous role dealing with PIP Regulations and Statutes Arbitration experience is a plus Must have strong attention to detail and ability to read, analyze and assess data Strong written and verbal communication skills Must be open to change and be able to rapidly adapt to new information or unexpected obstacles. Must be able to demonstrate strong problem-solving skills and the ability to make sound decisions Ability to multi-task Bachelor's Degree is a plus but not required Proficient skills in Microsoft, Word, Excel and Outlook. Working knowledge of all or any of the following is a plus: Guidewire Claim Center, Mitchell Decision Point, OnBase Unity Client, Agile Point Compensation: This role may be filled at PAL Adjuster, or PAL Adjuster, Senior level based on skills, experience and credentials. PAL Adjuster: $59,744 - $75,360 PAL Adjuster, Sr: $79,129 - $91,833 Compensation: Salary is commensurate with experience and credentials. Pay Range: $61,256-$77,255 Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses. Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
    $79.1k-91.8k yearly Auto-Apply 20d ago
  • Claims Adjuster

    Property Loss Services Inc.

    Claims representative job in Southampton, NJ

    Job DescriptionBenefits: Bonus based on performance Competitive salary Health insurance Opportunity for advancement Paid time off Benefits/Perks: Competitive Pay Professional Development Job Stability in a Growing Industry Job Summary: PLS Claims is seeking an experienced Senior Property Field Adjuster with five (5) or more years of property field adjusting experience to support our growing New Jersey operations. This is a permanent position offering a strong long-term growth opportunity for the right professional The ideal candidate is highly organized with strong analytical and writing skills. About PLS Claims Founded in 1997, PLS Claims is an Independent Adjusting and Third-Party/Delegated Claims Administration firm headquartered in Georgia. We proudly represent a diverse client base that includes domestic insurance carriers, select Underwriters at Lloyds, self-insured entities, and other third-party administrators. We are committed to fostering a collaborative, positive, and professional work environment where team members are supported, mentored, and held accountable, allowing every team member to grow and succeed. We offer a competitive salary with quarterly bonus potential, mileage reimbursement, reimbursement for approved continuing education, and contribution towards employer sponsored group medical insurance with an HSA option, company paid Life/AD&D /STD & LTD insurance, paid Personal Time Off, and a SIMPLE IRA plan. Position Overview This role will cover all areas of New Jersey and will initially involve working alongside our current New Jersey General Adjuster, who will be transitioning out of the role. The successful candidate will assume responsibility for handling claims for our existing clients, as well as supporting future client growth. This is a high-visibility position with direct client interaction. The Senior Property Adjuster will be responsible for full-cycle adjustment of both personal and commercial property claims, including complex losses. Key Responsibilities Conduct full property adjustments for personal and commercial lines claims, including: Building Personal property Business income / Loss of Use (LOU) Perform thorough claim investigations and evaluations from first notice through resolution Accurately track time and expenses; claims are billed on a Time & Expense basis Prepare clear, professional, and well-documented reports and claim correspondence Identify coverage issues, liability considerations, and subrogation opportunities Navigate claims efficiently toward fair and timely resolution using sound judgment and situational awareness Required Qualifications Minimum of 5 years of property field adjusting experience (required) Strong knowledge of: Residential and commercial building construction General building valuation Personal property and time element losses Ability to review and interpret policy coverages from a wide range of insurers, including non-standard and manuscript forms Proficiency with Xactimate Proficiency in Microsoft Word and Excel Strong organizational and time management skills with the ability to consistently meet deadlines Excellent written communication skills, including the ability to clearly and concisely document events, damages, and conclusions using proper grammar and punctuation Experience preparing: Requests for Information (RFIs) Reservation of Rights letters Full and partial denial letters Sworn Statements in Proof of Loss Subrogation receipts and related claim documentation Strong investigative, evaluation, and negotiation skills Inquisitive mindset with a natural curiosity and attention to detail Ability to work effectively with a wide variety of people and personalities Valid drivers license with a good driving record Preferred (Not Required) AIC and/or CPCU designations
    $52k-68k yearly est. 22d ago
  • Claims Specialist

    Shiftsmart 4.3company rating

    Claims representative job in New York, NY

    Why Shiftsmart We're building the Amazon of labor. We're a labor platform pairing end-to-end workforce management technology with a rapidly growing global network of 5M flexible workers to create scalable labor solutions for the largest companies in the world, like Circle K, Pepsi, Dollar General, Starbucks and more. Our unique business model fractionalizes jobs down to shifts and makes it easy for workers to work across multiple companies through a digital marketplace. We're one of the fastest-growing startups in the country. We've grown 2-3x each year since we started and raised $120M+ from top-tier investors including D1 Capital & Imaginary Ventures …and we're only getting started. Our mission is to build the world's leading platform for hourly workers and enterprises enabling flexibility, choice, and upward social mobility. Join a rocketship. This is a unique opportunity to join the ground floor of a rapidly scaling business that is changing the way hourly labor works and capturing a $2 trillion dollar opportunity in the US alone. Ownership + impact. Join a team that is challenging and supporting one another to build a great business and create flexibility, choice, and upward social mobility for workers everywhere. Captain your career path. Enjoy accelerated learning and growth working with a world-class team from top tech companies (e.g. Uber, Airbnb, Google, Amazon), business schools (e.g. HBS, GSB, Wharton), and professional services (e.g. Bain, BCG, Goldman). Become a world-class executor. We believe that #ExecutionIsBinary, and are dedicated to helping you master that skill for life here and beyond. Mission: The mission of the Privacy and Compliance function is to ensure Shiftsmart processes and policies adhere to relevant legal and regulatory requirements and ensure positive & safe experiences for both users, clients, and company. You will be directly contributing in helping create and maintain a resource for both customers and users to assist with any privacy or legal related requests. This role is based in New York City (HQ) with typically 4+ days in office Outcomes: This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.This position will evolve over time but some of your early responsibilities will include: Gather, organize, and analyze information related to incidents and escalated complaints. Support the creation of comprehensive written investigative reports based on gathered data. Perform initial analysis of all escalated incidents and complaints, considering factors such as location, type of task, and the nature of the issue. Coordinate closely with the Customer, Support, and Operations teams to compile relevant data, records, and other evidence necessary for investigative reports. Maintain a robust tracking system to monitor the outcomes of all escalations and investigated cases. Meet response time SLAs for communicating with partners, law enforcement contacts, and customer contacts. Competencies: Experience: You have 1-2 years of experience in employee relations, as a claims analyst, or in an investigatory role with the potential, motivation and ambition to grow and thrive in a fast-paced environment. Communication: You have excellent communication skills and enjoy helping people feel heard, know how to ask the important questions, and analyze the relevant information into a report Results driven: Takes pride in & has a track record of hitting or exceeding targets; persists in accomplishing objectives despite obstacles or setbacks. You thrive in an environment where success is measured in metrics and improvement Collaboration: Ability to work closely with all areas of the company to be a problem solver. This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation. Highly organized: You plan, organize and execute in a highly structured way & relish bringing formality to ambiguity, ruthlessly prioritize, and feel organization is second nature to you. Independent: Able to function with a high-level of autonomy once given a playbook. Compensation philosophy To provide greater transparency we share base salary ranges, which are based on role and level benchmarked against similar stage, high growth companies. Offers are determined based on multiple factors including skills, work experience, and relevant credentials. In addition to competitive salaries and meaningful equity we offer the following benefits: Comprehensive healthcare coverage: We cover 100% of employee premiums for medical, dental, and vision care (60-75% for dependents) 401(k) match program: We match 100% on the first 3% of your contributions and 50% on the next 2% for a maximum match of 4% Generous, fully paid parental and family leave policies Pre-tax commuter benefits Collaborative office with fully stocked kitchen @ 1 World Trade in Manhattan Equal opportunity employer Shiftsmart is committed to creating a diverse environment and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Operating Principles @ Shiftsmart Inspired by Leadership Principles @ Amazon Execution Is Binary We #GetShiftDone. We take immense pride in both the quality of our work and our relentless determination to deliver on our commitments. If we say we are going to do something, we do it. We own the outcome with an unstoppable mindset through the finish line and are impatient to move the ball forward. This means we work really hard, execute with urgency, and ruthlessly challenge timelines for anything important. As a result, we do not defer responsibility to other teams or individuals. Instead, we take the problem as far as we can and only when needed ask others for help. Each time a crisis or opportunity emerges we take the hill as one team, because we are allergic to the words “it can't be done” . Missionaries, Not Mercenaries We before me. We believe in our mission to build a better world for workers. We understand why our work matters and take seriously how it impacts our customers and our partners. This belief permeates everything we do from the strategic to the mundane. We are energetic, ambitious, and want to win. We constantly raise the standards for ourselves and everyone around us. We show up for our customers, our partners, and most importantly our teammates, and make every effort to build lasting relationships with each of them. We do not measure success based on our titles or the size of our empires. This also means we put the needs of the business before the details of our job descriptions. Rather than fight for a bigger piece of the pie, we fight to grow the entire thing and recognize this is how to grow our careers too. Inputs > Outcomes We work really hard. Fundamentally changing how labor works is not easy. It often requires long days, late nights, and weekends to deliver on our commitments. We lean into this challenge. We focus on the process. We think in terms of value chains and appreciate that a bad process with a good outcome is simply dumb luck. We lead with data. We use facts, not fiction, to build narratives and make decisions. To do this we prepare written memos in advance and resist the urge to engage in endless water cooler what ifs, because we value the time and attention of our teammates. We hire and develop the best. When we decide to hire a new team member, we do so because we believe they will increase the talent density on our team. We view ourselves as leverage maximizers rather than inconvenience reducers and strive to increase the output of everyone we interact with. Honesty Over Harmony We share the truth even when it is painful. We do not, however, share the truth callously to hurt people's feelings or make them look bad. We also assume positive intent. If someone is not delivering in a way that we need, we ask them and tell them before assuming the worst. We embrace mutual feedback. As people leaders we care more about our team's growth and success than how much others like us. As individuals we seek, accept, and apply feedback. We do not give or take feedback personally because we understand it enables us to learn and grow. We tell the truth to ourselves. We reject a pollyannaish view of our world. Instead if something isn't going well that we are responsible for, we call it out. And when someone calls out their own truth that may be less optimal, we don't punish them for it. We have the meeting in the meeting. If something is broken or we disagree, we call it out and say something in the moment even if it feels uncomfortable to do so. This means that if something is broken, we do not just accept it and complain later. Invent & Iterate We are ********************* categorically reject the phrase “that is how it's always been done” , and constantly discover new and better ways to do more with less. This means we are resourceful and often do things that don't scale, only to create ways to scale them later. We're builders. We think BIG. At every level of the company, we embrace big, hairy, audacious, and transformative goals. We fear lack of progress and incremental thinking more than failing to deliver or falling short of an audacious goal. We believe courage means to try without fear and learn without ego. We do not let perfect get in the way of better. When faced with the choice we prioritize delivering something, even if imperfect, over endless debate and alignment. We embrace good mistakes.
    $58k-101k yearly est. Auto-Apply 60d+ ago
  • Independent Insurance Claims Adjuster in Trenton, New Jersey

    Milehigh Adjusters Houston

    Claims representative job in Trenton, NJ

    IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
    $53k-68k yearly est. Auto-Apply 60d+ ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claims representative job in Trenton, NJ

    At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
    $52k-67k yearly est. Auto-Apply 7d ago
  • Billing/Claims Specialist

    P4P

    Claims representative job in New York, NY

    Job DescriptionLocation: Brooklyn, NY Salary: $52K-$80KThe Billing and Claims Specialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials.Key Responsibilities for Billing/Claims Specialist: Billing & Claims Processing Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance Review authorizations, service hours, and eligibility prior to billing Ensure accurate coding and claim data in accordance with payer guidelines Process electronic and paper claims as required by payers Claims Follow-Up & Reconciliation Monitor claim status and follow up on unpaid, denied, or underpaid claims Investigate and resolve billing discrepancies and denials Submit corrected or resubmitted claims as needed Post payments, adjustments, and denials accurately into billing systems Reconcile remittance advice (EOBs/ERAs) with billed claims Authorization & Compliance Track MLTC authorizations, service limits, and expiration dates Ensure billing aligns with approved care plans and service authorizations Maintain compliance with Medicaid, MLTC, and insurance regulations Stay current on payer rule changes and billing requirements Qualifications for Billing/Claims Specialist: Required Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting Hands-on experience with MLTC billing and insurance claims Strong knowledge of Medicaid and managed care billing processes Proficiency with home care billing software and clearinghouses Excellent attention to detail and organizational skills
    $52k-80k yearly 14d ago
  • Transactional Risk Claims Specialist

    Hyperiongrp

    Claims representative job in New York, NY

    Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden. Classification: Exempt/Full-time Reports to: Head of Claims for Transactional Risk Travel: 0-15% Salary: $150,000.00-$215,000.00 Role overview DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team. The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice. This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time. Role responsibilities Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion. Assist with entering claim data into operational systems. Assist with quality control and performance management, to ensure high-quality claim handling. Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers. Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices. Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners. Perform other duties as assigned. Key requirements Bachelor's degree required and law degree preferred. Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable. Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions. Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives. Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint). Ability to manage multiple competing priorities. Ability to adapt to evolving regulatory and legal environments. Complete assigned tasks correctly, on time and able to learn quickly. Self-motivated and demonstrating attention to detail. Be able to work independently for extended periods. Excellent written and verbal communication skills as well as general business understanding. Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment. If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team. What do we offer in return? A career that you define. Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more. What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community. Our culture: people first Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world. The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key. Diversity and inclusion At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances. What do we offer in return? A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us: Our successes have all come from someone brave enough to try something new We support each other in the small everyday moments and the bigger challenges We are determined to make a positive difference at work and beyond Reasonable adjustments We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*. If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require. *Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more. Permanent
    $43k-77k yearly est. Auto-Apply 49d ago
  • Complex Claims Specialist-MPL

    Hiscox

    Claims representative job in New York, NY

    Job Type: Permanent Build a brilliant future with Hiscox Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlement of Miscellaneous Professional Liability insurance claims. May be responsible for single or multi-country claims and will be responsible for all aspects of the claims, including liaise with external and internal business partners (e.g., outside experts and/or or legal counsel; underwriting) as required. Bring your Passion and Enthusiasm to our Team! We are a fun, innovative and growing Claims team where you'll get the opportunity to learn multiple insurance products and interact with business leaders across the organization. Please note that this position is hybrid and requires two (2) days in office weekly. Position can be based in the following locations: Manhattan, NY West Hartford, CT Atlanta, GA Chicago, IL Boston, MA The Role: The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also: Adjusts and resolves complex to severe claims that includes all phases of litigation With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters Reviews and analyses claim documentation and legal filings Drives litigation best practices to lead defense strategy on litigated files Mentors Claim Examiners Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions Identifies emerging exposures and claims trends Identifies suspected fraudulent claims and tracks with special investigations unit Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities Develops content and conducts training for claims team and underwriters as requested The Team: The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling. Requirements: 8+ years of claims handling experience or 7-8 years litigation experience. (A JD from an ABA accredited law school may be considered as a supplement to claims handling experience.) Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Experience in mentoring and training other claims examiners Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University preferred Additional Factors Considered: Ability to act a subject matter expert within team Demonstrated ability to work with minimal oversight Experience attending and leading mediations, arbitrations and trials Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars. What Hiscox USA offers: 401(k) with competitive company matching Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care) Company paid group term life, short- term disability and long-term disability coverage 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days Paid parental leave 4-week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing 2023 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. Diversity and flexible working at Hiscox: At Hiscox we care about our people. We hire the best people for the job and we're committed to diversity and creating a truly inclusive culture, which we believe drives success. We also understand that working life doesn't always have to be ‘nine to five' and we support flexible working wherever we can. No promises, but please chat to our resourcing team about the flexibility we could offer for this role. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary range: $125,000-$155,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture
    $43k-77k yearly est. Auto-Apply 12d ago
  • Transactional Risk Claims Specialist

    Howden Group Holdings Ltd.

    Claims representative job in New York, NY

    Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden. * Classification: Exempt/Full-time * Reports to: Head of Claims for Transactional Risk * Travel: 0-15% * Salary: $150,000.00-$215,000.00 Role overview DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team. The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice. This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time. Role responsibilities * Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion. * Assist with entering claim data into operational systems. * Assist with quality control and performance management, to ensure high-quality claim handling. * Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers. * Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices. * Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners. * Perform other duties as assigned. Key requirements * Bachelor's degree required and law degree preferred. * Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable. * Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions. * Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives. * Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint). * Ability to manage multiple competing priorities. * Ability to adapt to evolving regulatory and legal environments. * Complete assigned tasks correctly, on time and able to learn quickly. * Self-motivated and demonstrating attention to detail. * Be able to work independently for extended periods. * Excellent written and verbal communication skills as well as general business understanding. * Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment. * If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team. What do we offer in return? A career that you define. Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more. What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community. Our culture: people first Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world. The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key. Diversity and inclusion At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances. What do we offer in return? A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us: * Our successes have all come from someone brave enough to try something new * We support each other in the small everyday moments and the bigger challenges * We are determined to make a positive difference at work and beyond Reasonable adjustments We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*. If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require. * Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more. Permanent
    $43k-77k yearly est. Auto-Apply 47d ago
  • Claims Specialist

    Sourcepro Search

    Claims representative job in New York, NY

    SourceProSearch is seeking a Claims Specialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office. Job Responsibilities: Format documents and communications for clients. Liaise between third-party vendors and the firm. Review documents (release/document verification) for production to defense counsel for quality control. Calendaring and entry of case info into the database. Perform intake and initial filtering of client inquiries. Preparation of submissions involving large volumes of individual claims. Run and analyze client data reports. Organize documents and communications with clients. Ensure that case documents accurately reflect a client's individual information. Keep track of communications or developments relating to client cases and deadlines that may be applicable to individual clients. Prepare and send client communications. Communicate with clients telephonically, on occasion. Work with attorneys to plan data gathering and settlement update workflows. Analyze and summarize client inquiries to identify trends and patterns requiring further action. Assist with the development of processes and technological systems for addressing large volumes of client interactions. Skills/Requirements: Proficient in the use of Microsoft Word and Excel. Familiarity with Filesite preferred. Familiarity with client management systems or databases preferred. Strong technical skills and ability to quickly learn new litigation support software. Strong written and oral communication skills and strong interpersonal skills. Must possess great attention to detail. Must possess analytical and critical thinking skills. Strong organizational and time-management skills. Ability to work independently while understanding the importance of teamwork. Ability to manage workload consisting of multiple tasks. The work shift for this position is 9:30 am-5:30 pm, five days a week, but the applicant must be willing and available to work overtime, both evening and weekends, when necessary. ****************************
    $43k-77k yearly est. 60d+ ago
  • Claims Specialist

    Shiftsmart 4.3company rating

    Claims representative job in New York, NY

    Why Shiftsmart We're building the Amazon of labor. We're a labor platform pairing end-to-end workforce management technology with a rapidly growing global network of 5M flexible workers to create scalable labor solutions for the largest companies and government agencies in the world like Circle K, Pepsi, Walmart, Starbucks and more. Our unique business model fractionalizes jobs down to shifts and makes it easy for workers to work across multiple companies through a digital marketplace. We're one of the fastest-growing startups in the country. We've grown 2-3x each year since we started, paid over $130M in wages to hourly workers, and raised $120M+ from top-tier investors including D1 Capital & Imaginary Ventures…and we're only getting started. Mission: The mission of the Privacy and Compliance function is to ensure Shiftsmart processes and policies adhere to relevant legal and regulatory requirements and ensure positive & safe experiences for both users, clients, and company. You will be directly contributing in helping create and maintain a resource for both customers and users to assist with any privacy or legal related requests. This role is based in New York City (HQ) with typically 4+ days in office Outcomes: This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.This position will evolve over time but some of your early responsibilities will include: * Gather, organize, and analyze information related to incidents and escalated complaints. * Support the creation of comprehensive written investigative reports based on gathered data. * Perform initial analysis of all escalated incidents and complaints, considering factors such as location, type of task, and the nature of the issue. * Coordinate closely with the Customer, Support, and Operations teams to compile relevant data, records, and other evidence necessary for investigative reports. * Maintain a robust tracking system to monitor the outcomes of all escalations and investigated cases. * Meet response time SLAs for communicating with partners, law enforcement contacts, and customer contacts. Competencies: * Experience: You have 1-2 years of experience in employee relations, as a claims analyst, or in an investigatory role with the potential, motivation and ambition to grow and thrive in a fast-paced environment. * Communication: You have excellent communication skills and enjoy helping people feel heard, know how to ask the important questions, and analyze the relevant information into a report * Results driven: Takes pride in & has a track record of hitting or exceeding targets; persists in accomplishing objectives despite obstacles or setbacks. You thrive in an environment where success is measured in metrics and improvement * Collaboration: Ability to work closely with all areas of the company to be a problem solver. This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation. * Highly organized: You plan, organize and execute in a highly structured way & relish bringing formality to ambiguity, ruthlessly prioritize, and feel organization is second nature to you. * Independent: Able to function with a high-level of autonomy once given a playbook. Compensation philosophy To provide greater transparency we share base salary ranges, which are based on role and level benchmarked against similar stage, high growth companies. Offers are determined based on multiple factors including skills, work experience, and relevant credentials. In addition to competitive salaries and meaningful equity we offer the following benefits: * Comprehensive healthcare coverage: We cover 100% of employee premiums for medical, dental, and vision care (60-75% for dependents) * 401(k) match program: We match 100% on the first 3% of your contributions and 50% on the next 2% for a maximum match of 4% * Generous, fully paid parental and family leave policies * Pre-tax commuter benefits * Collaborative office with fully stocked kitchen @ 1 World Trade in Manhattan Equal opportunity employer Shiftsmart is committed to creating a diverse environment and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Operating Principles @ Shiftsmart Inspired by Leadership Principles @ Amazon Execution Is Binary We #GetShiftDone. We take immense pride in both the quality of our work and our relentless determination to deliver on our commitments. If we say we are going to do something, we do it. We own the outcome with an unstoppable mindset through the finish line and are impatient to move the ball forward. This means we work really hard, execute with urgency, and ruthlessly challenge timelines for anything important. As a result, we do not defer responsibility to other teams or individuals. Instead, we take the problem as far as we can and only when needed ask others for help. Each time a crisis or opportunity emerges we take the hill as one team, because we are allergic to the words "it can't be done". Missionaries, Not Mercenaries We before me. We believe in our mission to build a better world for workers. We understand why our work matters and take seriously how it impacts our customers and our partners. This belief permeates everything we do from the strategic to the mundane. We are energetic, ambitious, and want to win. We constantly raise the standards for ourselves and everyone around us. We show up for our customers, our partners, and most importantly our teammates, and make every effort to build lasting relationships with each of them. We do not measure success based on our titles or the size of our empires. This also means we put the needs of the business before the details of our job descriptions. Rather than fight for a bigger piece of the pie, we fight to grow the entire thing and recognize this is how to grow our careers too. Inputs > Outcomes We work really hard. Fundamentally changing how labor works is not easy. It often requires long days, late nights, and weekends to deliver on our commitments. We lean into this challenge. We focus on the process. We think in terms of value chains and appreciate that a bad process with a good outcome is simply dumb luck. We lead with data. We use facts, not fiction, to build narratives and make decisions. To do this we prepare written memos in advance and resist the urge to engage in endless water cooler what ifs, because we value the time and attention of our teammates. We hire and develop the best. When we decide to hire a new team member, we do so because we believe they will increase the talent density on our team. We view ourselves as leverage maximizers rather than inconvenience reducers and strive to increase the output of everyone we interact with. Honesty Over Harmony We share the truth even when it is painful. We do not, however, share the truth callously to hurt people's feelings or make them look bad. We also assume positive intent. If someone is not delivering in a way that we need, we ask them and tell them before assuming the worst. We embrace mutual feedback. As people leaders we care more about our team's growth and success than how much others like us. As individuals we seek, accept, and apply feedback. We do not give or take feedback personally because we understand it enables us to learn and grow. We tell the truth to ourselves. We reject a pollyannaish view of our world. Instead if something isn't going well that we are responsible for, we call it out. And when someone calls out their own truth that may be less optimal, we don't punish them for it. We have the meeting in the meeting. If something is broken or we disagree, we call it out and say something in the moment even if it feels uncomfortable to do so. This means that if something is broken, we do not just accept it and complain later. Invent & Iterate We are ********************* categorically reject the phrase "that is how it's always been done", and constantly discover new and better ways to do more with less. This means we are resourceful and often do things that don't scale, only to create ways to scale them later. We're builders. We think BIG. At every level of the company, we embrace big, hairy, audacious, and transformative goals. We fear lack of progress and incremental thinking more than failing to deliver or falling short of an audacious goal. We believe courage means to try without fear and learn without ego. We do not let perfect get in the way of better. When faced with the choice we prioritize delivering something, even if imperfect, over endless debate and alignment. We embrace good mistakes.
    $58k-101k yearly est. 60d+ ago
  • Billing/Claims Specialist

    P4P

    Claims representative job in New York, NY

    Location: Brooklyn, NY Salary: $52K-$80K The Billing and Claims Specialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials. Key Responsibilities for Billing/Claims Specialist: Billing & Claims Processing Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance Review authorizations, service hours, and eligibility prior to billing Ensure accurate coding and claim data in accordance with payer guidelines Process electronic and paper claims as required by payers Claims Follow-Up & Reconciliation Monitor claim status and follow up on unpaid, denied, or underpaid claims Investigate and resolve billing discrepancies and denials Submit corrected or resubmitted claims as needed Post payments, adjustments, and denials accurately into billing systems Reconcile remittance advice (EOBs/ERAs) with billed claims Authorization & Compliance Track MLTC authorizations, service limits, and expiration dates Ensure billing aligns with approved care plans and service authorizations Maintain compliance with Medicaid, MLTC, and insurance regulations Stay current on payer rule changes and billing requirements Qualifications for Billing/Claims Specialist: Required Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting Hands-on experience with MLTC billing and insurance claims Strong knowledge of Medicaid and managed care billing processes Proficiency with home care billing software and clearinghouses Excellent attention to detail and organizational skills
    $52k-80k yearly 13d ago
  • Complex Claims Specialist - Cyber, Technology, Media & Crime

    Hiscox

    Claims representative job in New York, NY

    Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture
    $43k-77k yearly est. Auto-Apply 13d ago

Learn more about claims representative jobs

How much does a claims representative earn in Brick, NJ?

The average claims representative in Brick, NJ earns between $35,000 and $82,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.

Average claims representative salary in Brick, NJ

$53,000
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