Claims representative jobs in Glen Burnie, MD

At least twenty-four (24) Medicaid related Claims Analyst and Claims Processors are needed for a long-term project in DC. These positions are 100% onsite and located downtown, near Farragut North Metro Station. The Midtown Group is teaming up with a leading technology company to support a D.C. government department that offers its residents a Medicaid program. Our collective goal is to modernize and optimize DC's Medicaid program while offering outstanding customer support. Our venture is focused on improving outcomes, enhancing provider experiences, and safeguarding program integrity. For this project, our partner will provide technology, and we will provide people and expertise across several functions, including contact center operations. Claims Analyst and Claims Processors will support D.C. medical providers who need assistance with Medicaid benefits. These positions are in-person, located in Downtown D.C. There are no plans to move to hybrid or fully remote models. Interviews begin on Tuesday, 12/9/25, and these engagements are expected to start on 1/16/26 and may continue for up to two or three years or longer. Key job tasks Claims/Financial Analyst/Processors have several job responsibilities, and some of the critical ones are: · Handle refund checks and state warrants received from healthcare providers and the State agency. · Contact providers, verbal and in writing, to resolve check-related issues. · Receive and respond to client inquiries. · Responsible for handling the Accounts Receivable transfer process, setting up expenditures, setting up Accounts Receivable transactions, and placing and recoupment caps using the Medicaid system. · Responsible for analyzing financial data to ensure accurate reporting. · Research highly complex claims processing or financial transactions. · Process adjustments and voids. · Ensure SLAs are compliant with client and Midtown Group expectations · Other duties as assigned. Performance measurement The Midtown Group measures performance in a number of ways, with the key ones being: Quality Assurance assessments: may have their calls monitored and assessed at any time during a shift. We and our partner monitor and assess our CSRs regularly. CSRs are expected to maintain or exceed a QA pass rate of 90%+. Calls are considered to have failed if a CSR misses or incorrectly performs any critical element of the job. These items are well-covered in training and reinforced during pre-shift and individual coaching sessions. Call handling metrics are a good measure of performance and the three focus areas are: Percent of your shift that you are either on a call or available to take a call. Length of call. We are here to provide efficient, professional assistance, so a consistent track record of very long or very short calls is generally frowned upon. Percent of calls that you transfer. This often indicates that a CSR is unable or unwilling to assist callers. Attendance Minimum requirements · High School Diploma or equivalent, 2-year post-high school Degree, or bachelor's degree. · A minimum of two years of previous experience for a government or private sector operations center in a similar or related field. · Two to four years of working experience in claims processing and financial analysis. · Organization skills to balance/prioritize work with the ability to multi-task. · Proficiency with basic help desk software, computer software and Microsoft Office applications. · Problem-solving skills to bring inquiries to effective resolution. · Customer service skills, with an emphasis on written and oral communication, to professionally and efficiently respond to inquiries. Other important skills The ability to provide operational excellence is extremely important to both the Midtown Group and our client. If you have the service gene - if helping others is in your DNA - we are happy to have you join us. Our most effective and successful Claims/Financial Analyst/Processors exhibit the following skills: · Conduct themselves with professionalism, empathy, patience, courtesy, and tact, at all times. · Communicate effectively, clearly, and professionally. · Quickly and effectively process transactions and analyze financial data, to a high standard. Operational quality is very important to us. · Know when and how to collaborate and escalate to quickly and effectively address and resolve issues. · Effectively collect and handle sensitive data and personal information, as needed. · Exercise good judgment at all times. · Deal well with conflict, as well as complex and emotional situations. · Be flexible, and able to work independently. Hours, project duration, etc. The contact center operating hours are Monday through Friday, from 8:00am to 5:00pm ET. However, schedules will be between the hours of 7:45am to 5:15pm ET, to allow for pre-shift sessions and last-minute contacts/wrap up. The contact center is closed on Federal holidays. Candidates must be able to work 40 hours per week. The base period for this contract is through November 2026, with two further annual option periods. So, this contract could run until November 2028.

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $67,000.00 - $110,600.00 **Target Openings** 1 **What Is the Opportunity?** This role is eligible for a sign on bonus Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered. **What Will You Do?** + Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability + Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. + Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate. + Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome. + Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits. + Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment. + Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. + Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + 2 years Workers Compensation claim handling experience. + Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. + Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. + Ability to effectively present file resolution to internal and/or external stakeholders. + Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. + General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. + Principles of Investigation: Intermediate investigative skills including the ability to take statements. + Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. + Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. + Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. + Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed. + WC Technical: + Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. + Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. + Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Customer Service: + Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. + Teamwork: + Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. + Planning & Organizing: + Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. + Maintain Continuing Education requirements as required or as mandated by state regulations. **What is a Must Have?** + High School Diploma or GED. + 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers . If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 What Is the Opportunity? This role is eligible for a sign on bonus Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered. What Will You Do? Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate. Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome. Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits. Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment. Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. Perform other duties as assigned. Additional Qualifications/Responsibilities What Will Our Ideal Candidate Have? 2 years Workers Compensation claim handling experience. Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders. Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. Principles of Investigation: Intermediate investigative skills including the ability to take statements. Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed. WC Technical: Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. Teamwork: Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. Planning & Organizing: Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. Maintain Continuing Education requirements as required or as mandated by state regulations. What is a Must Have? High School Diploma or GED. 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program.

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job CategoryClaimCompensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range$67,000.00 - $110,600.00Target Openings1What Is the Opportunity?This position could be eligible for a sign on bonus. LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.What Will You Do? Handles 1st party property claims of moderate severity and complexity as assigned. Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. Broad scale use of innovative technologies. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. Establishes timely and accurate claim and expense reserves. Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. Writes denial letters, Reservation of Rights and other complex correspondence. Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. Meets all quality standards and expectations in accordance with the Knowledge Guides. Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. Manages file inventory to ensure timely resolution of cases. Handles files in compliance with state regulations, where applicable. Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. May provides mentoring and coaching to less experienced claim professionals. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. Must secure and maintain company credit card required. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. Perform other duties as assigned. What Will Our Ideal Candidate Have? Bachelor's Degree preferred. General knowledge of estimating system Xactimate preferred. Two or more years of previous outside property claim handling experience preferred. Interpersonal and customer service skills - Advanced Organizational and time management skills- Advanced Ability to work independently - Intermediate Judgment, analytical and decision making skills - Intermediate Negotiation skills - Intermediate Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate Investigative skills - Intermediate Ability to analyze and determine coverage - Intermediate Analyze, and evaluate damages -Intermediate Resolve claims within settlement authority - Intermediate Valid passport preferred. What is a Must Have? High School Diploma or GED required. A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required. Valid driver's license required. What Is in It for You? Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we're looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person. If you're ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow. Build your future with us The Field Claims department is currently seeking Field Claims Representatives to service the territory surrounding: Towson Maryland. The candidate is required to reside within the territory. This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements. Be Ready to: * complete thorough claim investigations * interview insureds, claimants, and witnesses * consult police and hospital records * evaluate claim facts and policy coverage * inspect property and auto damages and write repair estimates * prepare reports of findings and secure settlements with insureds and claimants * use claims-handling software, company car and mobile applications to adjust loss in a paperless environment * provide superior and professional customer service * once eligible, become a certified and active Arbitration Panelist To be an Entry Level Claims Representative: Salary: The pay range for this position is $60,500 - $83,600 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * a desire to learn about the insurance industry and provide a great customer experience * the ability to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * a bachelor's degree * AINS, AIC, or CPCU designations preferred Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match To be an Experienced Claims Representative: Salary: The pay range for this position is $68,200- $99,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * multi-line claims experience preferred * ability to completely assess auto, property, and bodily injury type damages * capacity to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational, and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * one or more years of claims handling experience * AINS, AIC, or CPCU designations preferred * bachelor's degree or equivalent experience required Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match Enhance your talents Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you're new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional - all while enjoying a meaningful career. Enjoy benefits and amenities Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities. Embrace a diverse team As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to learn more about those rights.

Established in 1991, Collabera is one of the fastest growing end-to-end information technology services and solutions companies globally. As a half a billion dollar IT company, Collabera's client-centric business model, commitment to service excellence and Global Delivery Model enables its global 2000 and leading mid-market clients to deliver successfully in an increasingly competitive marketplace. With over 8200 IT professionals globally, Collabera provides value-added onsite, offsite and offshore technology services and solutions to premier corporations. Over the past few years, Collabera has been awarded numerous accolades and Industry recognitions including. Collabera awarded Best Staffing Company to work for in 2012 by SIA. (hyperlink here) Collabera listed in GS 100 - recognized for excellence and maturity Collabera named among the Top 500 Diversity Owned Businesses Collabera listed in GS 100 & ranked among top 10 service providers Collabera was ranked: 32 in the Top 100 Large Businesses in the U.S 18 in Top 500 Diversity Owned Businesses in the U.S 3 in the Top 100 Diversity Owned Businesses in New Jersey 3 in the Top 100 Privately-held Businesses in New Jersey 66th on FinTech 100 35th among top private companies in New Jersey *********************************************** Collabera recognizes true potential of human capital and provides people the right opportunities for growth and professional excellence. Collabera offers a full range of benefits to its employees including paid vacations, holidays, personal days, Medical, Dental and Vision insurance, 401K retirement savings plan, Life Insurance, Disability Insurance. Job Description Claims Initiation Analyst II: Receives incoming calls and assists customers with questions or issues regarding potential fraudulent activity on a deposit account (checking, savings) . Takes appropriate action based on an evaluation of the customer's needs which may include, filing a new claim(s), updating and follow-up on existing claim(s), and/or reviewing appeals on denied claims. Takes personal ownership to ensure that customer requests are processed quickly and efficiently, while maintaining compliance with industry regulations and bank procedures. Responsibilities include but are not limited to: initiating claims using multiple systems and tools, providing first call resolution on inquiries, and may assist the customer in resolving disputes directly with the merchant. May debit or credit customer's accounts, as appropriate. May research and resolve other general customer account inquiries as appropriate and/or escalate issues on the customer's behalf while providing world class customer service. Understand and adhere to established service level agreements and set appropriate expectation with the clients and customers regarding the claims process. Ideal candidate will have credit card knowledge in a customer service contact center. Qualifications Critical Skills: * Claims experience (in financial industry, preferrably but not required) * Customer service experience (in a call center environment, preferred but not required) * credit card experience (preferred but not required) Additional Information Should you have any questions, please feel free to call me on ************. Email your resume to: ********************************

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with: Furnishes reports with supporting information necessary to resolve disputes or defend against the claims, Prepares and assembles appeal files, Participates in meetings or negotiations with claimants, Appears in legal proceedings, Prepares cost estimates for use in claims negotiations, Prepares risk assessments/analysis relative to claim exposures, Prepares findings of fact and other documentation required by the CO. Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models. Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred. Submit resumes and project list in MS Word or PDF format: Please No Calls

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** As a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States. Responsibilities include: + Developing relationships with internal colleagues for fact-finding and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all aspects of product liability mass tort litigations and complex general liability cases. + Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country. + Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases. + Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records. + Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel. + Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. **Required Qualifications** + 2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. + Juris Doctor degree from an ABA accredited university. + Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. **Preferred Qualifications** + Experience overseeing or defending product liability claims and litigation. + Familiarity or experience with insurance and coverage issues related to litigated claims. + Strong attention to detail and project management skills. + Experience overseeing and answering written discovery. + Ability to work independently and in an environment requiring teamwork and collaboration. + Strong written and verbal communication skills. + Demonstrated negotiation skills and ability. + Ability to articulate and summarize cases with management in a concise, cogent manner. + 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. + 3-5 years of legal or claims experience. + Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations. + Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery. + Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel. + Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems. + Ability to positively and aggressively represent the company at mediation, arbitration and trial. + 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 high volume of litigated claims. + Experience with and understanding of legal documents (pleadings, discovery, motions and briefs). **Education** + Verifiable Juris Doctor degree **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: 01/03/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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.

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.

JOB TITLE: Claims Analyst This position is responsible for assisting with following up on administrative appeals and documentation submitted to health insurers and governmental payers; working well with attorneys and paralegals; maintaining the workload. DUTIES AND RESPONSIBILITIES: Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue. Determines action required to resolve the underpayment and initiate that action, including submitting appeals and reconsideration requests. Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement Quickly and efficiently prepares, reviews, and submits well-written claims correspondence and related documents to insurers Is skilled, aggressive, cordial, and professional on the telephone to follow up on submitted appeals. Performs other related duties as assigned by management. QUALIFICATIONS: Bachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience. Other skills required : BA/BS with a GPA of 3.0 or higher. Interest in healthcare and healthcare law. Able to navigate through various computer systems and applications to find information about insurance claims. Ability to prioritize and multi-task. Excellent written and verbal communication skills. Proficiency in Microsoft Office, including Word and Excel. Excellent organizational and time management skills. High attention to detail. Clear, concise, and logical writing style. COMPETENCIES: Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures. Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals. Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values. External Working Relationships - Develops and maintains courteous and effective working relationships with clients, vendors and/or any other representatives of external organizations. Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.

The Claims Analyst will perform a variety of "changes and claims" related contract administration tasks. An ideal candidate requires experience in transit projects through design, construction and commissioning phases. The Claims Analyst will be responsible for coordinating and reviewing claims / changes and engaging, strategizing, and working with various Program / Project teams to undertake the merit assessment, mitigation, and resolution of claims. The role requires commercial claim knowledge, and preferably also technical understanding, of multiple subject areas related to implementation of a large transit infrastructure projects. Responsibilities Maintain claims and early warnings' register. Review alleged claims. Carry out initial triage and risk assessment of claims. Review project correspondence, and track and report on project claims. Interface with the contractor and other stakeholders, as required, to gather additional details etc. Attend various technical and commercial project working group meetings. Requirements Required Skills: Critical thinking skills sufficient to apply analytical techniques to assess claims. The ability to liaise effectively and to work closely with various multi-disciplinary technical and project controls teams Proficiency with Microsoft Office Suite, particularly Excel. Strong organization, time management, and prioritization skills with proven ability to balance competing tasks and meet deadlines. Self-directed, detail-oriented, excellent at meeting deadlines with well-developed time management skills. Excellent communication (both written and verbal), teamwork, and interpersonal skills. Required Qualifications: Bachelor's degree in engineering, business or other relevant degree. 1 - 4 years of relevant experience Position Location Field: Hybrid - 2 or 3 days in program office

Do you thrive on uncovering the story behind project delays and turning data into defensible insights? Join PEMCCO as a Claims Analyst/Forensic Scheduler, where you'll perform detailed schedule and delay analyses to assess time and cost impacts on construction projects. In this role, you'll support dispute resolution and litigation preparation by developing clear, evidence-based findings and narrative documentation that stand up to scrutiny. PEMCCO, Inc. is an Information Technology and Information Management (IT/IM) services firm. We assist our customers in maximizing existing and emerging technologies to achieve their desired business productivity objectives. Living the Culture and Making It Happen is the motto we live by. We Live the Culture by carrying out the tenets of our Core Values of Loyalty, Integrity, and Commitment to our Customers and Employees every day. We Make It Happen by following Smart Organization Healthy Organization (SOHO) principles for internal and external communications and the successful execution of projects. Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. Essential Functions * Reconstruct as‑built schedules from field data, daily reports, and contractor updates. * Perform critical path delay analysis, disruption quantification, and time‑impact modeling. * Prepare expert‑level claims narratives with exhibits, graphics, and correlation charts. * Support negotiations, mediations, and expert testimony preparation. * Interface with project management, legal counsel, and technical advisors. * Maintain a documentation library compliant with DGS and COMAR record‑keeping requirements. Competencies * Mastery of forensic scheduling, claims causation, and delay quantification. * Excellent analytical, research, and report‑writing skills. * Familiarity with contract law, AIA, and MD GMP provisions, and time‑extension protocols. Required Qualifications * Bachelor's degree in Engineering, Construction, or related field. * 10+ years of schedule or claims analysis experience, including public capital programs. * Must pass client background screening and security clearance. Preferred Qualifications * AACE CFCC or PSP certification. * Experience in forensic schedule analysis for DGS, MDOT, or SHA. Benefits * 15 days of Paid Time Off * 11 Paid Holidays * Medical, Dental, and Vision * Voluntary Short-Term Disability, Life Insurance, Accident, Critical Illness, Hospital Indemnity, Whole Life Plus, Identity Theft, and Law Assure * 401(k) * Employee Assistance Program (EAP) Compensation * $145 - $175 hourly, depending on experience, ability, and capability. The role requires full-time, on-site presence in Baltimore, MD. Candidates must be able to reliably commute; relocation expenses are not provided. PEMCCO, Inc. is an equal-opportunity employer. The Company does not discriminate based on race, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, military or veteran status, pregnancy, childbirth, and related medical conditions, or any other characteristics protected by applicable federal, state, or local law.

Do you thrive on uncovering the story behind project delays and turning data into defensible insights? Join PEMCCO as a Claims Analyst/Forensic Scheduler, where you'll perform detailed schedule and delay analyses to assess time and cost impacts on construction projects. In this role, you'll support dispute resolution and litigation preparation by developing clear, evidence-based findings and narrative documentation that stand up to scrutiny. PEMCCO, Inc. is an Information Technology and Information Management (IT/IM) services firm. We assist our customers in maximizing existing and emerging technologies to achieve their desired business productivity objectives. Living the Culture and Making It Happen is the motto we live by. We Live the Culture by carrying out the tenets of our Core Values of Loyalty, Integrity, and Commitment to our Customers and Employees every day. We Make It Happen by following Smart Organization Healthy Organization (SOHO) principles for internal and external communications and the successful execution of projects. Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. Essential Functions Reconstruct as‑built schedules from field data, daily reports, and contractor updates. Perform critical path delay analysis, disruption quantification, and time‑impact modeling. Prepare expert‑level claims narratives with exhibits, graphics, and correlation charts. Support negotiations, mediations, and expert testimony preparation. Interface with project management, legal counsel, and technical advisors. Maintain a documentation library compliant with DGS and COMAR record‑keeping requirements. Competencies Mastery of forensic scheduling, claims causation, and delay quantification. Excellent analytical, research, and report‑writing skills. Familiarity with contract law, AIA, and MD GMP provisions, and time‑extension protocols. Required Qualifications Bachelor's degree in Engineering, Construction, or related field. 10+ years of schedule or claims analysis experience, including public capital programs. Must pass client background screening and security clearance. Preferred Qualifications AACE CFCC or PSP certification. Experience in forensic schedule analysis for DGS, MDOT, or SHA. Benefits 15 days of Paid Time Off 11 Paid Holidays Medical, Dental, and Vision Voluntary Short-Term Disability, Life Insurance, Accident, Critical Illness, Hospital Indemnity, Whole Life Plus, Identity Theft, and Law Assure 401(k) Employee Assistance Program (EAP) Compensation • $145 - $175 hourly, depending on experience, ability, and capability. The role requires full-time, on-site presence in Baltimore, MD. Candidates must be able to reliably commute; relocation expenses are not provided. PEMCCO, Inc. is an equal-opportunity employer. The Company does not discriminate based on race, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, military or veteran status, pregnancy, childbirth, and related medical conditions, or any other characteristics protected by applicable federal, state, or local law.

Requirements Requires a high school diploma; advanced education beyond high school preferred or an equivalent combination of education and experience. Previous experience as a claims adjuster or must complete Capstone specified adjuster training if no experience. If previous adjuster experience, working knowledge of Xactimate is preferred. Must be licensed, or have the ability to obtain license(s), as required by state and local jurisdictions to adjust insurance claims. Must have valid driver's license. Skills and Competencies: Ability to work in a high volume, fast paced environment managing multiple tasks. Ability to provide excellent service to policyholders and clients. Ability to efficiently operate a computer and related claims and business software. Effective analytical and problem-solving skills necessary to make decisions and resolve conflict Good verbal and written communication skills. Good attention to detail. Strong analytical and mathematical ability. Ability to work independently in a virtual environment when required. Good organizational and time management skills. Physical Demand Requirements: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this position, auto travel is required. Ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a vehicle. Ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics. Ability to work in a confined or restricted area. Kneeling, crouching, crawling, standing, sitting, walking, pushing, pulling, etc. as is required to inspect claims. Ability to work outdoors, exposed to all weather conditions.

MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar. Responsibilities Main Duties: Performs review and analysis of construction claims. Assists with development of contractor claims. Develops and/or review time extension requests. Assist with development of expert reports and exhibits. Qualifications Education B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree. P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred. Skills and Abilities Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Experience drafting expert reports and deliverables. Proficient in Oracle P6 required and experienced with Microsoft Project desired. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration. Ability to relate technical knowledge to a non-technical audience. Proficiency in reading/understanding construction plans and specifications. Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint. Experience providing training, supervision, proposal development, and business development desired. Occasional overnight travel may be required. STATUS: Full-time BENEFITS: Competitive compensation with opportunities for semi-annual bonuses Generous Paid Time Off and holiday schedules 100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual) Health Savings Account with company contribution 401(k)/Roth 401(k) plan with company match Tuition Assistance and Student Loan Reimbursement Numerous Training and Professional Development opportunities Wellness Program & Fitness Program Reimbursement Applicants must be authorized to work in the U.S. without sponsorship. MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.

You will work in the field and report to the Property Claim Manager and handle homeowner property field claims typically within the Baltimore, MD area. You must be located within that metro area. A company fleet vehicle is provided with the position and there's an option to use the vehicle for personal use. Location: In this primarily field-based role, you will spend 80% of your time (4+ days per week) working in the field, directly interacting with customers. On occasion you may be asked to travel to an office location for in person engagement activities such as team meetings, trainings, and culture events. Position Compensation Range: $56,000.00 - $92,000.00 Pay Rate Type: Salary Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates. Primary Accountabilities You will investigate the origin and cause of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc. You will identify complex issues and seek assistance as needed. Handles claims on a good-faith basis. You will handle both 1st party and 3rd party claims under multiple policy types and numerous endorsements. You will conduct on-site inspections when needed, evaluate damages, and handle claim negotiations with insureds, claimants, attorneys, and public adjusters. You will respond to customer inquiries, make appropriate decisions, and close files as needed. You will interpret and determine policies, leases, by-laws, declarations, articles and contract coverages and apply to all parties for assigned losses. You will proactively provide all parties with the claim process and status as appropriate; answer questions or redirect to other areas. Specialized Knowledge & Skills Requirements Demonstrated experience providing customer-driven solutions, support, or service. Demonstrated experience handling 1st and 3rd party, multi-line claims across our operating territories, or other equivalent experience. Demonstrated experience handling moderately complex claims, or other equivalent experience. Solid knowledge and understanding of policies and endorsements related to casualty coverages, or other equivalent knowledge. Solid knowledge and understanding of each phase of the claim handling process, or other equivalent knowledge. Licenses Valid driver's license required plus an acceptable driving record. Obtain state specific property casualty claims licensing as required. Travel Requirements Up to 50%. Catastrophe duty up to 75% as applicable. Physical Requirements Ascending or descending ladders, stairs, scaffolding, ramps, poles and the like. This position may require employees to visit areas that have a higher hazard than a typical office such as customer homes, body shops, or other locations. Moving self in different positions to accomplish tasks in various environments including tight and confined spaces. Adjusting or moving objects up to 50 pounds in all directions. Additional preferred qualifications: Familiarity and experience with Xactimate. #LI-Remote Additional Information Offer to selected candidate will be made contingent on the results of applicable background checks Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions Sponsorship will not be considered for this position unless specified in the posting The candidate(s) selected for this role will be employed by AFICS, Inc. (American Family Insurance Claims Services, Inc.), an affiliate of American Family Mutual Insurance Company, S.I. We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits. We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. American Family Insurance is committed to the full inclusion of all qualified individuals. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please email *************** to request a reasonable accommodation. #LI-JA2