Workers Comp Claims Representative
Claims representative job in Syracuse, NY
Our Workers Comp Claims team is currently seeking a Claims Representative to join our Level One team in our Worcester, MA, Syracuse, NY, or Itasca, IL offices. This is a full-time/non-exempt role. Responsible for the investigation and resolution of complex medical only and lost time claims of low complexity in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insured's and claimants through the claim process and options.
IN THIS ROLE, YOU WILL:
Must have or secure and maintain appropriate states adjuster license(s) and continuing education credits.
Work within specific limits and authority on assignments of moderate technical complexity.
Use discretion and independent judgment in claim handling.
Possess functional knowledge and skills reflective of fully competent practitioner.
Identify possibly suspicious claims.
Investigate, analyze, evaluate and negotiate personal and/or commercial lines claims of minimal to moderate complexity.
Responsible for managing all aspects of each claim and maintaining a high level of productivity, confidentiality and customer service.
Implement and coordinate the most effective management techniques to mitigate loss and expense payments.
Reserving and expense authority levels are moderate.
Work with the Special Investigations Unit, where appropriate.
May be required to have and maintain sufficient home-based internet connection.
WHAT YOU NEED TO APPLY:
Typically has 1 - 3 years experience
Technical knowledge in WC coverages
Excellent written and verbal communication skills
Knowledge of medical terminology
Must possess organizational skills with regard to time management, task prioritization and integration of information from a variety of sources
Excellent and proficient data entry skills
High level of proficiency in Word, Excel and use of the Internet
Ability to meet and/or exceed the goals and metrics of the role on a consistent basis
Self-directed and self-motivated
Possesses strong customer service skills and behaviors
Makes decisions in an informed, confident and timely manner
Maintains constructive working relationships despite differing perspectives
Strong organizational and time management skills
Ability to negotiate skillfully in difficult situations with both internal and external groups
Demonstrates ability to win concessions without damaging relationships
Demonstrates strong written and verbal communication skills.
Promotes and facilitates free and open communication
Understanding of applicable statutes, regulations and case law
Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner
Easily adapts to new or different changing situations, requirements or priorities
Cultivates an environment of teamwork and collaboration
Operates with latitude for un-reviewed action or decision
Computer experience (MS Office, excel, word, etc)
Proficient using Claims systems (i.e. CSS, PMS, etc.)
Ability to use a personal computer and other standard office equipment
Ability to travel as necessary
Ability to sit and/or stand for extended periods
Workload requirements may routinely call for work hours in excess of 40 hours per week
This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.
Claims Analyst
Claims representative job in Syracuse, NY
Conducts analysis around various claims payment processes to ensure accuracy of system configuration and provider payments.
Additional Information
Please let me know if you are available/interested so we can further discuss this position you can reach me @732- 983-4337
Independent Insurance Claims Adjuster in Syracuse, New York
Claims representative job in Syracuse, NY
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.
Auto-ApplyClaims Adjuster II
Claims representative job in Syracuse, NY
We're thrilled that you are interested in joining us here at the Amynta Group!
As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines.
Responsibilities:
Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature.
Determine coverage, compensability, potential for subrogation recovery, and other offsets (when applicable).
Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims.
Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.
Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure.
Negotiate claims settlements with carriers approval.
Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition.
Work collaboratively with medical professionals to develop and execute return to work strategies.
Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome.
Maintain a working knowledge of New York State requirements and applicable case law for NY.
Demonstrate technical proficiency through timely, consistent execution of best claim practices.
Communicate effectively, verbally and in writing, with internal and external parties on a wide variety of claims and account issues.
Provide a high degree of customer service to clients, including but not limited to day to day interactions, claims reviews and renewal meetings.
Authorize medical treatment based on protocols established by NYS WC law
Assist Underwriting on new and renewal business
Requirements:
Claims Adjusters License required
Bachelor's degree, or four or more years of equivalent work experience.
At least 3 or more years' experience handling New York State lost time workers compensation construction claims for
Associate in Claims (AIC) Designation or similar professional designation desired.
Familiarity with medical terminology.
Strong organizational skills and ability to manage multiple tasks simultaneously.
Demonstrated ability to work independently and with a team.
Ability to analyze data and make sound decisions.
Strong verbal and written communication skills.
Strong Knowledge of OSHA construction standards
Knowledge of NYS labor Law §240
Computer literacy, including working knowledge of MS Office products including Word, Excel and PowerPoint. Knowledge of Claim Center a plus.
Ability to travel for business purposes, less than 15%.
The Amynta Group (the “Company”) is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any ground of discrimination protected by applicable human rights legislation. The information collected is solely used to determine suitability for employment, verify identity and maintain employment statistics on applicants.
Applicants with disabilities may be entitled to reasonable accommodation throughout the recruitment process in accordance with applicable human rights and accessibility legislation. A reasonable accommodation is an adjustment to processes, procedures, methods of conveying information and/or the physical environment, which may include the provision of additional support, in order to remove barriers a candidate may face during recruitment such that each candidate has an equal employment opportunity. The Company will accommodate a candidate to the point of undue hardship. Please inform the Company's personnel representative if you require any accommodation in the application process.
Auto-ApplyField Claims Adjuster
Claims representative job in Syracuse, NY
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.
Workers' Compensation Claims Representative | NY Lost-Time Experience | NY Licensing
Claims representative job in Syracuse, NY
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
Workers' Compensation Claims Representative | NY Lost-Time Experience | NY Licensing
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
Enjoy flexibility and autonomy in your daily work, your location, and your career path.
Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.
ARE YOU AN IDEAL CANDIDATE? To analyze New York Lost-Time claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
OFFICE LOCATION:
Syracuse, NY - candidates within reasonable commuting distance to office will be required to work a hybrid schedule
Remote for candidates with the right experience outside of commutable distance to Syracuse, NY
ESSENTIAL RESPONSIBILITIES MAY INCLUDE
Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
Negotiating settlement of claims within designated authority.
Communicating claim activity and processing with the claimant and the client.
Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
QUALIFICATIONS
Education & Licensing: 1 - 2 years of claims management experience or equivalent combination of education and experience required.
High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Jurisdiction Knowledge: NY
Licensing: NY
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Opportunity to work in an agile environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
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 (60K - 70K). 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.
#LI-BP1
#claims
#claimsexaminer
#remote
#LI-remote
#hybrid
#LI-hybrid
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.
Auto-ApplySenior Workers' Compensation Claims Specialist (NY)
Claims representative job in New Hartford, NY
The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an "A" rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier.
Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago.
Primary hiring locations include Woodbury, NY (Long Island); New Hartford, NY; Buffalo, NY; Charlotte, NC.
What you will do
In this role, you'll use your customer service experience, investigative skills, and detail orientation to handle more serious and complex claims in primarily NY jurisdictions. Communicating with our insureds, attorneys, and other relevant parties will be required in this role. With technical claims knowledge, you'll also use your decision making skills to settle claims within your assigned authority.
Key responsibilities
* Include performing all duties and responsibilities as outlined for Claims Specialist.
* Investigating and handling primarily New York Workers' Compensation claims of a complex and serious nature, and other jurisdictions as needed.
* Performing special claims investigation and handling matters requiring broad technical claims knowledge.
* Operating on an independent basis with little supervision.
* Settling claims within assigned authority.
* Numerous contact with attorneys concerning serious claim matters.
* Reviewing court decisions, law and coverage interpretations. Broad knowledge and understanding of the law and claim practices.
* May assume duties of the Claims Supervisor in the Supervisor's absence.
What you need
* 4-year degree in business administration or equivalent experience.
* 1-2 years as Claims Specialist or 3-4 years adjusting experience.
* Experience with New York jurisdictions strongly preferred.
Licensing:
Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.
Salary range: $73,000-$100,000
The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.
Benefits
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
* Medical and Prescription Drug Benefit
* Dental Benefit
* Vision Benefit
* Life Insurance and Disability Benefits
* 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
* Health Savings Account (HSA)
* Flexible Spending Accounts
* Tuition Assistance, Training, and Professional Designations
* Company-Paid Family Leave
* Adoption/Surrogacy Assistance Benefit
* Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance
* Student Loan Refinancing Services
* Care.com Membership with Back-up Care, Senior Solutions
* Business Travel Accident Insurance
* Matching Gifts program
* Paid Volunteer Day
* Employee Referral Award Program
* Wellness programs
Additional information
This position is a full time salaried, exempt (non overtime eligible) position.
Utica National is an Equal Opportunity Employer.
Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.
#LI-HL1
Global Risk Solutions Claims Specialist Development Program (January, June 2026)
Claims representative job in East Syracuse, NY
Claims Specialist Program
Are you looking to help people and make a difference in the world? Have you considered a position in the fast-paced, rewarding world of insurance? Yes, insurance!
Insurance brings peace of mind to almost everything we do in our lives-from family trips to your first car to weddings and college graduations. As a valued member of our claims team, you'll help our customers get back on their feet and restore their lives when catastrophe strikes.
The details
When you're part of the Claims Specialist Program, you'll acquire various investigative techniques and work with experts to determine what caused an accident and who is at fault.
You'll independently manage an inventory of claims, which may include conducting investigations, reviewing medical records, and evaluating damages to determine the severity of each case. You'll resolve cases by working with individuals or attorneys to settle on the value of each case.
You will have required comprehensive training, one-on-one mentoring, and a strong pay-for-performance compensation structure at a global Fortune 100 company. Make a difference in the world with Liberty Mutual.
Qualifications
What you've got
You have 0-2 years of professional experience.
A strong academic record with a cumulative 3.0 GPA preferred
You have an aptitude for providing information in a clear, concise manner with an appropriate level of detail, empathy, and professionalism.
You possess strong negotiation and analytical skills.
You are detail-oriented and thrive in a fast-paced work environment.
You must have permanent work authorization in the United States.
What we offer
Competitive compensation package
Pension and 401(k) savings plans
Comprehensive health and wellness plans
Dental, Vision, and Disability insurance
Flexible work arrangements
Individualized career mobility and development plans
Tuition reimbursement
Employee Resource Groups
Paid leave; maternity and paternity leaves
Commuter benefits, employee discounts, and more
Learn more about benefits at **************************
A little about us
As one of the leading property and casualty insurers in the country, Liberty Mutual is helping people embrace today and confidently pursue tomorrow.
We were recognized as a ‘2018 Great Place to Work' by Great Place to Work US, and were named by
Forbes
as one of the best employers in the country for new graduates and women-as well as for diversity.
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.
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Auto-ApplySmall Commercial Field Property Adjuster
Claims representative job in East Syracuse, NY
Property Adjusters investigate commercial property claims, evaluate damages, determine coverage, set accurate loss cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Negotiate settlement of claims with varying complexity and perils.
Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory.
This role is open to both Grades 12 to 13.
Responsibilities:
Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss. Reviews and utilizes financial statements to adjust moderately sized business interruption losses.
Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposure.
Engages and manages consultants and independent adjusters as required. Monitors the costs to ensure they are reasonable and necessary.
Establishes and maintains accurate loss cost estimates and reserves for each claim for reporting, financial records, and other purposes.
Keeps the Insured and others informed about the claim's status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching. Determines depreciation of claim.
Affirms or denies coverage of the claim based on the facts and the policy terms and conditions. Develops information necessary to make advance, partial and final payments when appropriate.
Meet time requirements of the policy and fair claims handling practices.
Effectively negotiate settlement of claims of varying complexity and perils. Achieves a prompt, fair and equitable settlement of a claim, where there is policy liability.
Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflect the adjustment activities and substantiate any payments made.
May participate in quality assurance file review sessions and serve as a technical resource for less experienced claims personnel.
Will be called upon for catastrophe duty.
Qualifications
Knowledge of property insurance; commercial property claims; coverage evaluation; claims investigation, loss assessment, evaluation and reserves; financial analyses; insurance regulations.
Negotiation and settlement of moderate to high complexity claims.
Other skills required include a focus on customers; decision making; results oriented; spoken communication; and adaptability.
An ability to build relationships, listen (i.e., comprehend nuances and acknowledge others' viewpoints), mentoring and training less experienced team members, write business correspondence, produce accurate work, manage projects and vendors.
Use core applications/spreadsheets.
As normally acquired through a bachelor's degree or equivalent; successful completion of required internal training programs and AIC (Associate in Claims) modules 33 and 35.
Prefer designations such as AIC, SCLA, CPCU, etc, and at least 2-3 year of progressively responsible experience.
Ability and willingness to travel to the site of catastrophe for assignments that may last several weeks.
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
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Auto-ApplyClaims Specialist - NY
Claims representative job in Liverpool, NY
Job Description
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
This is a remote role.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
Ability to learn rapidly to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to meet or exceed performance competencies
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year of industry experience and claims management preferred
State Certification as an Experienced Examiner
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $51,807 - $83,551
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL
CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Daily Property Field Adjuster
Claims representative job in Syracuse, NY
Job Description
Alacrity Solutions
Independent Contractor
Daily Property Field Adjuster
Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit **************************
The objective of a Daily Property Field Adjuster is to provide excellent claim handling services for our clients regarding daily claim work within your area which can include multiple perils.
Contract Requirements Include:
A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay.
Skills & Requirements/Licensure:
MUST live within 50-100 miles of posted location and willing to travel to location.
Minimum 2-3 years property field adjusting experience.
Independent adjusting license in your home state (area of work), or a designated home state license if residing in a non-licensing state.
Experienced in wind, hail, theft, fire, water losses and other perils preferred.
Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities.
Willing and able to climb roofs.
Computer and Phone System Requirements:
Smart Cell Phone able to access to internet.
Xactimate and/or Symbility proficient with current subscription
Working Laptop computer with reliable high-speed internet
Digital camera and other miscellaneous items necessary to perform adjuster responsibilities.
Working Conditions / Physical & Mental Demands:
The physical demands described here are representative and must be met by the independent contractor to successfully perform this job.
100% travel is required within designated working territory based on the location of assignments received.
Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus.
Why Choose Alacrity?
Flexibility: Self-determined Scheduling
Diversity Statement
Alacrity Solutions is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other characteristic protected by applicable laws.
How Long We Retain Personal Information:
We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws.
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Senior Claims Compliance Analyst
Claims representative job in Ava, NY
Job Type:
Permanent
Build a brilliant future with Hiscox
Please note that this position is hybrid and requires work in office a minimum of two (2) days per week. Position can be based at our following hub office locations:
Atlanta, GA
Chicago, IL
Manhattan, NY
Scottsdale, AZ
West Hartford, CT
The US Claims Compliance and Quality Assurance team at Hiscox is a growing group of professionals with operational and technical experience. The team serves as a claims technical resource, as well as provides assistance and expertise across Hiscox by identifying and promoting claims best practices and facilitating required improvements. We foster consistency, calibration, and continuous improvement in the handling of Hiscox claims. Our team is quite diverse, and you will be able to demonstrate that you can flex your work and delivery style to accommodate different stakeholders.
You'll play a critical role in safeguarding our organization from regulatory risk. This is a high-impact role suited for an experienced insurance claims compliance professional or attorney, with deep knowledge of insurance claims regulations, processes, and technology. This role is ideal for someone who can translate risk into actionable strategy and build sustainable compliance practices as Hiscox USA grows.
Key Responsibilities
Manage and maintain 50-state claims database
Monitor legislation, DOI bulletins, court reporters/decisions, and statutory changes; manage backlog and implement targeted compliance training
Develop and own controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocols
Partner with Claims Technical, US Legal, and IT to design controls and workflows aligned with regulatory requirements
Lead US Claims response to regulatory inquiries and complaints
Deliver training and legal support to internal teams and vendors
Develop audit programs and dashboards to monitor compliance effectiveness
Oversee/support technology-related compliance integrations
Provide executive reporting, trends analysis, and regulatory insights
Qualifications
10+ years of experience in claims compliance, insurance regulation, or legal operations
J.D. highly desired
Degree in law, risk management, or a related field; required
Advanced insurance compliance certifications a plus (CPCU, CIPP, CAMS, CRCM, or similar) Scrum/PMP a plus but not required
Deep understanding of claims handling regulations, Medicare protocols, and market conduct standards
Experience with multiple lines of business in a 50-state claims environment
Knowledge of Medicare Secondary Payer requirements and Section 111 reporting
Strong research and policy writing skills
Excellent collaboration, project management, and problem-solving skills
Experience with regulatory audit preparation and response
Compensation: $90,000-$140,000 based on experience
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.
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 several major cities - New York, Atlanta, Chicago, West Hartford, and Scottsdale. 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.
What We Offer:
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
2024 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
You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance).
#LI-AJ1
Work with amazing people and be part of a unique culture
Auto-ApplyClaims Analyst
Claims representative job in Syracuse, NY
Job Title: Claims Analyst Duration: 1+ months contract racuse , New York 13212 Hours: Mon- Fri 9 am to 5:30 Job Description : Conducts analysis around various claims payment processes to ensure accuracy of system configuration and provider payments. Investigates problem claims to determine root cause of problem and/or error to address both individual claim resolution and improvement to process to avoid issues from occurring in the future. Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments. Testing categories include but are not limited to the following: Benefit, Contract, and Fee Schedule Configuration, System Enhancements, Report Validation, Validation of electronic file loads.
EDUCATION:
At least one year claims knowledge.
Looking for medical claims experience for these position.
Top Three: Claims knowledge, efficient and work well with a group
Required Education: High School graduate (or GED).
Required Experience: 0-2 years of claims processing with advancement to auditing / claims analysis / claims research.
Some project management skills. Good oral and written communication skills. Advanced Word and Excel skills.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Independent Insurance Claims Adjuster in Ithaca, New York
Claims representative job in Ithaca, NY
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.
Auto-ApplyField Claims Adjuster
Claims representative job in Ithaca, NY
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.
Small Commercial Field Property Adjuster
Claims representative job in East Syracuse, NY
Property Adjusters investigate commercial property claims, evaluate damages, determine coverage, set accurate loss cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Negotiate settlement of claims with varying complexity and perils.
Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory.
This role is open to both Grades 12 to 13.
Responsibilities:
* Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss. Reviews and utilizes financial statements to adjust moderately sized business interruption losses.
* Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposure.
* Engages and manages consultants and independent adjusters as required. Monitors the costs to ensure they are reasonable and necessary.
* Establishes and maintains accurate loss cost estimates and reserves for each claim for reporting, financial records, and other purposes.
* Keeps the Insured and others informed about the claim's status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching. Determines depreciation of claim.
* Affirms or denies coverage of the claim based on the facts and the policy terms and conditions. Develops information necessary to make advance, partial and final payments when appropriate.
* Meet time requirements of the policy and fair claims handling practices.
* Effectively negotiate settlement of claims of varying complexity and perils. Achieves a prompt, fair and equitable settlement of a claim, where there is policy liability.
* Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflect the adjustment activities and substantiate any payments made.
* May participate in quality assurance file review sessions and serve as a technical resource for less experienced claims personnel.
* Will be called upon for catastrophe duty.
Qualifications
* Knowledge of property insurance; commercial property claims; coverage evaluation; claims investigation, loss assessment, evaluation and reserves; financial analyses; insurance regulations.
* Negotiation and settlement of moderate to high complexity claims.
* Other skills required include a focus on customers; decision making; results oriented; spoken communication; and adaptability.
* An ability to build relationships, listen (i.e., comprehend nuances and acknowledge others' viewpoints), mentoring and training less experienced team members, write business correspondence, produce accurate work, manage projects and vendors.
* Use core applications/spreadsheets.
* As normally acquired through a bachelor's degree or equivalent; successful completion of required internal training programs and AIC (Associate in Claims) modules 33 and 35.
* Prefer designations such as AIC, SCLA, CPCU, etc, and at least 2-3 year of progressively responsible experience.
* Ability and willingness to travel to the site of catastrophe for assignments that may last several weeks.
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
Auto-ApplyClaims Specialist - NY
Claims representative job in Liverpool, NY
Job Description
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
This is a remote role.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
Ability to learn rapidly to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to meet or exceed performance competencies
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year of industry experience and claims management preferred
State Certification as an Experienced Examiner
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $51,807 - $83,551
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
About CorVel
CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Daily Property Field Adjuster
Claims representative job in Syracuse, NY
Alacrity Solutions
Independent Contractor
Daily Property Field Adjuster
Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit **************************
The objective of a Daily Property Field Adjuster is to provide excellent claim handling services for our clients regarding daily claim work within your area which can include multiple perils.
Contract Requirements Include:
A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay.
Skills & Requirements/Licensure:
MUST live within 50-100 miles of posted location and willing to travel to location.
Minimum 2-3 years property field adjusting experience.
Independent adjusting license in your home state (area of work), or a designated home state license if residing in a non-licensing state.
Experienced in wind, hail, theft, fire, water losses and other perils preferred.
Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities.
Willing and able to climb roofs.
Computer and Phone System Requirements:
Smart Cell Phone able to access to internet.
Xactimate and/or Symbility proficient with current subscription
Working Laptop computer with reliable high-speed internet
Digital camera and other miscellaneous items necessary to perform adjuster responsibilities.
Working Conditions / Physical & Mental Demands:
The physical demands described here are representative and must be met by the independent contractor to successfully perform this job.
100% travel is required within designated working territory based on the location of assignments received.
Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus.
Why Choose Alacrity?
Flexibility: Self-determined Scheduling
Diversity Statement
Alacrity Solutions is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other characteristic protected by applicable laws.
How Long We Retain Personal Information:
We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws.
Auto-ApplyClaims Analyst I
Claims representative job in Syracuse, NY
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
Title
: Claims Analyst I
Location
: Syracuse, NY
Duration
: 3+ Months (Possible extension)
Responsibilities
:
·
Mon- Fri 9am to 5:30 with OT possibly
·
Processing claims about 60 a day
·
Manager would like to have at least one year claims knowledge. Looking for medical claims experience for these position
·
Top Three: Claims knowledge, efficient and work well with a group
·
This is a fast paced environment. These positions have been created to hit a deadline
·
Interviews: Phone screens first and then face to face
Summary
:
·
Conducts analysis around various claims payment processes to ensure accuracy of system configuration and provider payments.
·
Investigates problem
claims to determine root cause of problem and/or error to address both individual claim resolution and improvement to process to avoid issues from occurring in the future. Perform and execute various claims process testing requests to ensure desired results are met to support accurate claims payments.
·
Testing categories include but are not limited to the following:
Benefit, Contract, and Fee Schedule Configuration System Enhancements
·
Report Validation: Validation of electronic file loads.
Essential Functions
:
·
Performs claims systems testing and/or system analysis to ensure accuracy of the system
'
s configuration and provider payments.
·
Conducts research and root cause analysis on various claims issues to identify and resolve problem payment and configuration concerns.
·
Develops/creates test plans/scripts which to provide concise analysis and documented results of the testing outcomes based on configuration changes/updates to support new businesses, benefits, and contracts.
·
Applies knowledge of claims processing to provide feedback resulting in the improvement of claims processing by identifying configuration improvements and/or when manual interventions and workarounds are required for configuration/system limitations.
·
Complies with performance standards by completing assignments within the specified time.
Knowledge/Skills/Abilities
:
·
Excellent verbal and written communication skills
·
Ability to abide by
company
policies
·
Maintain regular attendance based on agreed-upon schedule
·
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
·
Ability to establish and maintain positive and effective work relationships with co-workers, clients, members, providers and customers.
Required Education
:
·
High School graduate (or GED) / AA preferred
Required Experience
:
·
0-2 years of claims processing with advancement to auditing / claims analysis / claims research. Level of autonomy/decision making required.
·
Mid-level decision making.
·
Some project management skills. Good oral and written communication skills. Advanced Word and Excel skills.
If you are not interested in looking at new opportunities at this time I fully understand. I would in that case be appreciative of any referrals you could provide from your network of friends and colleagues in the industry. We do offer a referral bonus that I'd be happy to extend to you if they turn out to be a great fit for my client.
Qualifications
n/a
Additional Information
Kind Regards
Sumit Agarwal
732-902-2125
Independent Insurance Claims Adjuster in Utica, New York
Claims representative job in Utica, NY
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.
Auto-Apply