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  • Insurance Claims Specialist

    Marubeni America Corporation 4.6company rating

    Claims representative job in New York, NY

    To be considered, please apply through the link here. We are seeking an experienced and independent Insurance Claims Specialist with 7+ years of multi-line claims experience to manage and resolve claims across Marine Cargo, Property & Casualty, Automobile, Workers' Compensation, and Liability/Litigation. The role also supports contract reviews by assessing insurance-related provisions to ensure alignment with policy coverage and claims protocols. The ideal candidate will also provide support to the Insurance Manager and General Manager on special insurance projects as needed, contributing to broader departmental goals and demonstrating flexibility beyond core claims duties. ESSENTIAL JOB DUTIES: Manage the end-to-end claims process for: -Marine cargo/inland transit -Commercial property and general liability -Automobile (fleet and HNOA) -Workers' Compensation (“WC”) -Litigated liability claims, including bodily injury and third-party property damage Handle end-to-end claims for marine, property, liability, auto (fleet/HNOA), WC, and litigated matters including bodily injury and third-party property damage. Review policies to assess coverage, exclusions, deductibles, and retentions Coordinate with brokers, carriers, adjusters, and Internal legal counsel Support contract review by evaluating insurance clauses (limits, AI, Waiver of Subrogation) and identifying potential risk/coverage gaps Draft claim notifications and ensure compliance with policy timelines Provide loss history, reserve, and claim summaries to assist with renewal preparation Collaborate with Legal, MGC, and MAC BU Operations to resolve claims Participate in claim reviews and strategic discussions in recovery efforts Support the GM and Insurance Manager with special insurance-related projects as needed, and demonstrate flexibility in cross-functional assignments. MINIMUM EDUCATION REQUIREMENTS: Bachelor's degree in insurance or business-related fields or equivalent experience. MINIMUM EXPERIENCE AND CAPABILITY REQUIREMENTS: 7+ years of insurance claims experience across multiple P&C lines, including marine and litigated claims. Strong working knowledge of insurance policy language, ISO forms, and manuscript policies. Familiarity with contractual risk transfer principles and ability to analyze insurance-related clauses. Experience coordinating with external counsel and adjusters on complex/litigated claims. Proficiency in claims systems, Microsoft Word and Excel, and document management platforms. Technically skilled in both claims handling and policy interpretation. Detail-oriented with excellent judgment and risk awareness. Confident in reviewing contract language from an insurance perspective. Collaborative and able to communicate effectively with both technical and non-technical stakeholders. Able to manage competing priorities and operate independently. Must have the ability to work with deadlines and work in a fast-paced and dynamic work environment. Requires excellent written and verbal communication skills. Must be able to work in a multi-cultural business environment. JOB-RELATED CERTIFICATION: CPCU, ARM, or AIC designation preferred
    $46k-71k yearly est. 13h ago
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  • Claims Representative, Auto Property Damage - Independent Agent Channel

    Plymouth Rock Assurance 4.7company rating

    Claims representative job in Parsippany-Troy Hills, NJ

    The Auto Property Damage Claims Representative is responsible for managing Auto Property Damage claims within our “Auto PD Claim Unit.” This role demands a high level of customer service, patience, and professionalism while working in a fast-paced environment with significant phone interaction. Strong customer service, organizational, verbal, and written communication skills are essential. The ability to navigate adversarial situations with professionalism is critical. Comparative negligence claim handling experience is a plus but not required. RESPONSIBILITIES Policy Analysis: Investigate and interpret policy provisions, endorsements, and conditions to determine coverage for automobile property claims. Identify and investigate contested coverage claims that may require a roundtable discussion. Claim Investigation: Investigate auto accidents to assess liability by interviewing first- and third-party claimants, witnesses, investigating officers, and other relevant parties. Secure and analyze pertinent records, documentation, and loss scene information to determine proximate cause, negligence, and damages. Claims Management: Evaluate and adjust reserves as necessary. Prepare dispatch instructions for field personnel to inspect vehicles. Negotiate and settle claims within individual authority limits and seek supervisor approval for claims exceeding authority or requiring additional guidance. Maintain effective follow-up systems on pending files, advising insureds, claimants, and brokers on claim status. Act as an intermediary between the company, preferred vendors, and customers to resolve disputes. Ensure adherence to privacy guidelines, laws, and regulations in claims handling. Subrogation and Legal Handling: Investigate and initiate subrogation processes when applicable. Handle and respond to special civil part lawsuits or intercompany arbitrations related to auto property damage claims. Administrative Duties: Manage a customer-focused phone environment by answering calls, returning voicemails, and responding to emails and text correspondence promptly. Process incoming and outgoing mail timely and in accordance with state guidelines. Complete other duties as assigned. QUALIFICATIONS Bachelor's degree required. A minimum of 1 year of related PD claim experience is welcomed but not required. Proficiency in personal computer skills, including Microsoft Office Suite. Ability to prioritize and manage multiple tasks effectively. Excellent communication, organizational, and customer service skills. SALARY RANGE The pay range for this position is $47,000 to $55,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. PERKS & BENEFITS 4 weeks accrued paid time off, 8 paid national holidays per year, and 2 floating holidays Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision) Annual 401(k) Employer Contribution Resources to promote Professional Development (LinkedIn Learning and licensure assistance) Robust health and wellness program and fitness reimbursements Various Paid Family leave options including Paid Parental Leave Tuition Reimbursement ABOUT THE COMPANY The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
    $47k-55k yearly 13h ago
  • Claims Adjuster

    DOWC

    Claims representative job in Parsippany-Troy Hills, NJ

    About Us Dealer Owned Warranty Company LLC is a leading provider of F&I (Finance and Insurance) partnership services in the automotive industry, offering a full suite of obligor and administrator services, top-of-the-line products, technology, and training. We understand the importance of leveraging process and technology in the F&I industry to drive revenue and ensure success. Our goal is to provide visibility, transparency, and the tools needed for our partners to build their wealth and achieve their goals. DOWC prides itself on taking care of its employees (We were voted one of the “Best Places to Work” three years in a row!), and we also offer award-winning products. All of our positions are fully on-site in Parsippany, NJ. Overview We are seeking a dedicated and motivated Claims Representative to join our dynamic team. This role is essential in providing exceptional customer support to our contract holders related to warranty claims. The ideal candidate will possess strong communication skills, professional phone etiquette, a keen attention to detail, a love for customer service, excellent problem resolution, and the ability to work effectively in a fast-paced and high-volume environment. This person will be solution-oriented and eager to learn a complex business. Opportunities for advancement within the department with training provided. Job Duties: Provide outstanding customer support via phone, email, and chat related to claims inquiries. Handle a high volume of inbound calls with a minimum of 40 calls answered per day. Assist contract holders with inquiries regarding products and services, ensuring a high level of satisfaction pertaining to our contract guidelines. Accurately log and track customer issues, inquiries, and requests in the incident management system from identification through resolution. Deliver timely and reliable roadside assistance to customers in need. Process payments accurately and efficiently to ensure a smooth customer experience. Communicate effectively with team members and customers to resolve issues promptly. Adjudicate simple claims and troubleshoot basic to intermediate product or service issues. Connect and triage customers calling in for a claim with the appropriate mechanical claims analysts. Demonstrate excellent phone etiquette while handling client interactions. Collaborate internal departments to streamline customer services with adherence to SLAs. Maintain a queue of ongoing support tasks and resolve all customer issues in a high-priority manner. Proactively communicate with leadership to escalate any issues for immediate resolution. Create a positive support experience through active listening, problem-solving, and professional communication. Analyze information and process documents to resolve issues prior to escalation. Develop product knowledge to become a subject matter expert and confidently address customer concerns. Participate in further training sessions to enhance product knowledge and service skills. Qualifications Minimum of 2+ years as a claims adjuster or role in a customer service/call center environment. Proven experience handling a high volume of inbound customer calls. Insurance claims or automotive industry highly preferred. Ability to resolve escalated issues with a sense of urgency. Strong business acumen with the ability to identify customer needs and recommend appropriate solutions. Excellent communication skills, both verbal and written. Proficiency in data entry and familiarity with MS office software applications. Ability to work independently as well as part of a team in a collaborative environment. Strong organizational skills with an emphasis on attention to detail. Superior sense of urgency and ability to complete tasks in a timely manner. Strong customer-first attitude and relationship building skills. Come join our growing team here in Parsippany! As NJ's Best Places to Work Honoree for three years in a row, we offer: Competitive compensation Medical, Dental, Vision, 401k matching, Life Insurance, medical expense card PTO and Sick Time Corporate events, team and culture building activities, employee awards and recognition, company trips and more! DOWC is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected Veteran status, sexual orientation, gender identity, gender expression, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact us for assistance.
    $53k-69k yearly est. 4d ago
  • Senior General Liability Claim Representative

    CWA Recruiting

    Claims representative job in Union, NJ

    Senior General Liability Claim Representative - Property & Casualty Insurance Industry Union County NJ The management of accounts and the processing of claims related to litigated matters in hotels, real estate, hospitality, liquor liability, general liability, and bodily injury cases is a specialized function. This role necessitates an individual with a personality geared toward customer satisfaction. Responsibilities also include the negotiation of claims that are under litigation. Candidates should have at least 3 to 5 years of experience in handling middle market claims and possess a college degree. A valid New York adjuster's license is essential, while licenses from other states are considered a plus.
    $48k-70k yearly est. 13h ago
  • Litigation Claims Adjuster - CGL

    Guard Insurance Group

    Claims representative job in Parsippany-Troy Hills, NJ

    Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities Are you a detail-oriented insurance professional with a strong background in Commercial General Liability (CGL) and litigation handling? Join our team as a Complex Liability Adjuster, where you'll play a crucial role in managing Commercial General Liability (CGL) and Business Owners Policy (BOP) claims with precision and expertise. Key Responsibilities: * Investigate, evaluate, and resolve CGL and BOP claims * Manage claims involving active litigation, working closely with legal counsel and external stakeholders. * Analyze policy coverage, determine liability, and negotiate settlements. * Maintain accurate documentation and ensure compliance with regulatory and company standards. * Communicate effectively with insureds, claimants, attorneys, and internal teams. Salary Range $80,000.00-$115,000.00 USD The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Qualifications * Prior experience adjusting liability claims with a proven track record in litigation, specifically involving Commercial General Liability and Business Owners Policy. * Juris Doctor (JD) degree preferred or bachelor's degree with prior experience adjusting liability claims. * Licensing: Active TX All Lines License, or willingness to obtain one at company's expense. * Exceptional written and verbal communication skills. * Strong organizational and computer skills. * Excellent time management skills with the ability to prioritize tasks effectively.
    $80k-115k yearly Auto-Apply 22d ago
  • Auto Claim Representative, I

    Travelers Insurance Company 4.4company rating

    Claims representative job in Morristown, NJ

    **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $55,200.00 - $91,100.00 **Target Openings** 4 **What Is the Opportunity?** This role is eligible for a sign on bonus up to $10,000 Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. **What Will You Do?** + Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. + Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. + Determine claim eligibility, coverage, liability, and settlement amounts. + Ensure accurate and complete documentation of claim files and transactions. + Identify and escalate potential fraud or complex claims for further investigation. + Coordinate with internal teams such as investigators, legal, and customer service, as needed. + Insurance License: In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + Three years of experience in insurance claims, preferably Auto claims. + Experience with claims management and software systems. + Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. + Strong analytical and problem-solving skills. + Proven ability to handle complex claims and negotiate settlements. + Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. **What is a Must Have?** + High School Diploma or GED required. + A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .
    $55.2k-91.1k yearly 60d+ ago
  • Claims and Change Specialist

    Luster National 3.9company rating

    Claims representative job in New York, NY

    We are seeking an experienced Claims and Change Specialist to join our team on major NY transit and infrastructure projects. This role is critical in managing project changes to ensure compliance with contractual requirements, budgetary constraints, and schedule commitments. The ideal candidate will have a strong background in claims and change management processes within large-scale heavy civil or transportation projects. This is a long-term, on-site position located in New York City. Responsibilities may include, but are not limited to, the following: Oversee and manage the change control process for a large-scale heavy-civil design-build contract, ensuring alignment with contract terms and client procedures while utilizing Unifier and other required tracking tools. Evaluate and confirm change requests submitted by the Design-Builder, adhering to contractual timelines and client guidelines. Conduct research and provide recommendations regarding the validity and merit of Notices of Change. Develop comprehensive documentation for each change request, including cost and schedule impact assessments in collaboration with project controls teams (estimators and schedulers). Partner with estimators, schedulers, and construction management teams to analyze potential impacts. Keep accurate and up-to-date records of all change orders and approvals within the authorized project change log. Lead meetings to address changes, resolve disputes, or clarify issues in coordination with construction management and contract administration teams. Deliver consistent status updates and reports to the project team on a weekly basis or more frequently as required. Assist in negotiating change orders by organizing sessions with the Design-Builder and PMT staff and preparing negotiation summaries. Ensure adherence to client C&D standards and procurement requirements throughout all change management activities. Provide support for audits and reviews related to change control processes. Attributes Excellent written and verbal communication and interpersonal skills. You are a persuasive communicator and skilled negotiator who builds trust across technical, legal, and executive audiences. Excellent multi-tasking and organizational skills. Strong analytical mindset with the ability to translate schedule and cost data into actionable commercial strategies. Collaborative mindset that fosters teamwork, trust, and positive relationships and thrives in multidiscipline, owner-representative environments. Natural curiosity, problem-solving abilities, and a passion for continuous improvement. Minimum Qualifications Bachelor's degree in Engineering, Construction Management, Business, or related field, or equivalent combination of education/experience. 7+ years of hands-on contracts, change order, or claims management experience on heavy-civil infrastructure programs, major transit or rail programs, including at least one project exceeding $500 million total contract value. Experience with alternative delivery methods (e.g., DB, CM/GC, P3) and associated risk-allocation mechanisms. Demonstrated successful negotiation strategy and achieving favorable commercial outcomes for public sector transit owners or operators. Ability to interpret design documents, schedules, cost reports, and commercial terms to build clear entitlement narratives and quantum analyses. Proficiency with industry standard project management, schedule/cost and/or EDMS tools (e.g., P6, EcoSys, Unifier, MS Project, Bluebeam, etc.) Proficiency with Microsoft Office Suite/Office 365 (e.g., Outlook, Teams, Word, Excel, PowerPoint, etc.). Preferred Qualifications Master's degree in Engineering, Construction Management, Construction Law, or MBA. One or more of the following certifications: Project Management Professional (PMP through PMI), National Contract Management Association (NCMA) certifications such as Certified Professional Contracts Manager (CPCM) or Certified Contract Manager (CCM). Prior success steering claims through mediation, DRB, or litigation. Proficiency with Microsoft Power BI, Oracle Cloud Analytics, or other dashboard KPI reporting software. Compensation Details The salary range listed for this role is $145k-$176k/year ($70-$85/hour). The final salary offered will be based on multiple factors and thoughtfully aligned with each candidate's level of experience, breadth of skills, total education achieved, certifications/licenses that have been obtained, geographic location, etc. Just LOOK at the Benefits We Offer! Unlimited flexible time off Paid holidays Paid parental leave Health, dental, and vision insurance Flexible spending accounts (healthcare and dependent or elder care) Long-term disability insurance Short-term disability insurance Life insurance and accidental death and dismemberment 401(k) plan with guaranteed employer contribution Formal career planning and development program $2,500 annually toward professional development Wellness program with monthly wellness stipend Company cell phone or cell phone plan reimbursement Free personalized meal planning and nutrition support with a registered dietitian Free personal financial planning services Employee assistance program Employee discounts Employee referral bonus Specific plan details and coverage for each benefit noted above will be provided upon offer. #IN-LNJS Luster is committed to creating an inclusive work environment with a diverse workforce. All qualified applicants will receive consideration for employment without regard to criminal history, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. This employer participates in E-Verify. The employer will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS) with information from each new employee's I-9 to confirm work authorization. All positions may be subject to a background check and drug test once a conditional offer of employment is made for any convictions directly related to its duties and responsibilities, in accordance with all applicable local, state, and/or federal regulations. This job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position. Luster does not accept unsolicited resumes. In the absence of a signed agreement, Luster will not consider or agree to payment of any kind. Any unsolicited resumes presented to Luster personnel, including those submitted to Luster hiring managers, are deemed to be the property of Luster. Please email ***************** for accommodations necessary to complete the application process.
    $145k-176k yearly Auto-Apply 14d ago
  • Claims Specialist

    Berkley 4.3company rating

    Claims representative job in Parsippany-Troy Hills, NJ

    Company Details Berkley Luxury Group is an operating unit of W.R. Berkley Corporation, one of America's largest commercial lines writers in the United states. At Berkley Luxury Group we offer tailored, all-inclusive insurance solutions for luxury condo, co-op, rental properties and fine dining restaurants. Berkley Luxury Group has been a mainstay in the commercial real estate and hospitality business since 1986. We specialize in luxury condominiums, cooperatives, and apartments in the habitational space, Class A Office buildings and fine dining restaurants in the hospitality space. BLG maintains a standard of prompt and fair settlement of claims, and endeavors to treat insureds and brokers in a partnership-like manner. BLG has developed a strategic plan to grow their success by expanding their footprint geographically and adding complementary products. At BLG there is a shared vision to be the best option for its customers. We aim to provide comprehensive insurance solutions, use enhanced data and technology to make more informed decisions and rely on a field-based underwriting, claims and loss control model to be closer to our customers and brokers. Our goal is to provide superior services and products to these unique businesses. At Berkley Luxury Group, our employees are our most important asset. We recognize that if we properly support and develop our employees, they will become our primary sustainable competitive advantage and the key to achieving success. As such, we have created a high performing culture incorporating our values into work practices, policies, and processes to foster, reinforce and sustain an environment where employees share a strong sense of purpose, commitment, and motivation to meet and exceed their goals. As a Berkley company, we enjoy operational flexibility that allows us to deliver quality coverage solutions. W. R. Berkley Corporation, and all member insurance companies, are rated A+ (Superior) by A.M. Best Company and carry Standard & Poor's Financial Rating of A+ (Strong). The company is an equal opportunity employer. Responsibilities Berkley Luxury is seeking a Senior Claims Specialist to join our team! This role is located is our new Parsippany NJ office. As a Claim Specialist, you will manage a wide range of commercial lines casualty claims, focusing on developing and implementing effective resolution strategies while delivering exceptional customer service. In this role, you will ensure high-quality claims handling through investigation, accurate analysis of coverage and liability, precise damage assessment, and resolution of claims, including those in litigation. As a key member of the casualty team, you will also help foster a culture of accountability, collaboration, continuous learning, and proactive performance improvement-contributing to both departmental excellence and the overall success of the company. Conduct thorough investigation and expert analysis of claims facts to determine coverage, liability, and applies appropriate legal concepts to evaluate damages and recommend appropriate course of action. Analyze and interpret policy language and case law in conjunction with specific loss facts to reach appropriate coverage decisions and write appropriate coverage correspondence in compliance with state statutes and regulations. Demonstrate a strong sense of urgency in promptly conducting comprehensive claims investigations to assess damages and liability, establish accurate reserves, and actively pursue timely and appropriate resolutions. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposures, risk transfer, reserve adjustments, coverage issues, and claim resolution strategies. Resolve claims through negotiation, mediation, and arbitration with minimal assistance. Address inquiries from brokers and policyholders and provide superior customer service. Attend and participate in industry related conferences, seminars, and webinars and demonstrating a personal commitment to professional development. Ensure claims handling compliance and alignment with insurance regulations and Company policies. May participate in projects and other corporate initiatives such as audits, task forces, focus groups, etc. Other duties as required. Qualifications Education Bachelor's degree or equivalent experience JD degree a plus Experience 5-7 years of experience handling commercial general liability claims. Experience managing litigated claims and working with defense counsel. Proven track record of effective claims resolution and negotiation. Technical Skills Strong knowledge of claims investigation techniques, liability assessment, and damage evaluation. Demonstrated expertise in legal processes and litigation management. Ability to interpret and apply policy language accurately. Analytical & Decision-Making Demonstrated critical thinking and sound judgment in analyzing claims. Advanced analytical abilities to evaluate liability, quantify damages, and determine exposure. Proven capacity to make prompt, well-reasoned, and evidence-based decisions. Communication & Interpersonal Excellent written, verbal, and presentation communication skills. Effective communicator with diverse stakeholders, including policyholders, claimants, attorneys, and internal teams. Strong negotiation skills Organizational & Time Management Strong organizational skills with attention to detail. Effectively manages priorities and meets deadlines in a fast- paced environment. Team & Culture Fit Takes ownership, shows initiative, and approaches problem-solving with a proactive mindset. Collaborative team player dedicated to achieving shared goals. Committed to continuous improvement and ongoing professional development. Supports and upholds the company's commitment to equal employment opportunity. Additional Company Details The company is an equal opportunity employer. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role includes: Base Salary Range: $83,000 - $156,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Eligible to participate in the annual discretionary bonus program. Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. Sponsorship Details Sponsorship not Offered for this Role
    $83k-156k yearly Auto-Apply 60d+ ago
  • Multi-line Adjuster

    Geico 4.1company rating

    Claims representative job in New York, NY

    At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Multi-Line Property Damage Adjuster - New York City and surrounding areas. Salary: Starting pay rate varies based upon position and location. Ask your Recruiter for details! We are looking for a highly motivated and service-oriented individual to join our Multi-line Damage team as a Multi-line Property Damage Adjuster! As an ambassador for GEICO's renowned customer service, you will work in a dynamic environment that may include repair shops, salvage yards, a customer's home or in a virtual estimating environment. You will be responsible for inspecting damage, estimating cost of repairs, negotiating settlements, issuing payments, and providing excellent customer service. This position primarily will include servicing boat, motorcycle, RV and other specialty claims. Qualifications & Skills: Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits Must have a minimum of 1 year prior auto damage or estimating experience Willingness to be flexible with primary work location - position may require either remote or in-office work Solid computer, mechanical aptitude, and multi-tasking skills Effective attention to detail and decision-making skills Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities Minimum of high school diploma or equivalent, college degree or currently pursuing preferred Annual Salary $32.05 - $57.49 The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations. At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
    $32.1-57.5 hourly Auto-Apply 15d ago
  • Independent Insurance Claims Adjuster in Edison, New Jersey

    Milehigh Adjusters Houston

    Claims representative job in Edison, NJ

    IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
    $53k-69k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist

    Shiftsmart 4.3company rating

    Claims representative job in New York, NY

    Why Shiftsmart We're building the Amazon of labor. We're a labor platform pairing end-to-end workforce management technology with a rapidly growing global network of 5M flexible workers to create scalable labor solutions for the largest companies and government agencies in the world like Circle K, Pepsi, Walmart, Starbucks and more. Our unique business model fractionalizes jobs down to shifts and makes it easy for workers to work across multiple companies through a digital marketplace. We're one of the fastest-growing startups in the country. We've grown 2-3x each year since we started, paid over $130M in wages to hourly workers, and raised $120M+ from top-tier investors including D1 Capital & Imaginary Ventures… and we're only getting started. Mission: The mission of the Privacy and Compliance function is to ensure Shiftsmart processes and policies adhere to relevant legal and regulatory requirements and ensure positive & safe experiences for both users, clients, and company. You will be directly contributing in helping create and maintain a resource for both customers and users to assist with any privacy or legal related requests. This role is based in New York City (HQ) with typically 4+ days in office Outcomes: This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation.This position will evolve over time but some of your early responsibilities will include: Gather, organize, and analyze information related to incidents and escalated complaints. Support the creation of comprehensive written investigative reports based on gathered data. Perform initial analysis of all escalated incidents and complaints, considering factors such as location, type of task, and the nature of the issue. Coordinate closely with the Customer, Support, and Operations teams to compile relevant data, records, and other evidence necessary for investigative reports. Maintain a robust tracking system to monitor the outcomes of all escalations and investigated cases. Meet response time SLAs for communicating with partners, law enforcement contacts, and customer contacts. Competencies: Experience: You have 1-2 years of experience in employee relations, as a claims analyst, or in an investigatory role with the potential, motivation and ambition to grow and thrive in a fast-paced environment. Communication: You have excellent communication skills and enjoy helping people feel heard, know how to ask the important questions, and analyze the relevant information into a report Results driven: Takes pride in & has a track record of hitting or exceeding targets; persists in accomplishing objectives despite obstacles or setbacks. You thrive in an environment where success is measured in metrics and improvement Collaboration: Ability to work closely with all areas of the company to be a problem solver. This role will handle a diverse array of incidents and issues, but should always focus on solving for clarity, thoroughness, and risk mitigation. Highly organized: You plan, organize and execute in a highly structured way & relish bringing formality to ambiguity, ruthlessly prioritize, and feel organization is second nature to you. Independent: Able to function with a high-level of autonomy once given a playbook. Compensation philosophy To provide greater transparency we share base salary ranges, which are based on role and level benchmarked against similar stage, high growth companies. Offers are determined based on multiple factors including skills, work experience, and relevant credentials. In addition to competitive salaries and meaningful equity we offer the following benefits: Comprehensive healthcare coverage: We cover 100% of employee premiums for medical, dental, and vision care (60-75% for dependents) 401(k) match program: We match 100% on the first 3% of your contributions and 50% on the next 2% for a maximum match of 4% Generous, fully paid parental and family leave policies Pre-tax commuter benefits Collaborative office with fully stocked kitchen @ 1 World Trade in Manhattan Equal opportunity employer Shiftsmart is committed to creating a diverse environment and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Operating Principles @ Shiftsmart Inspired by Leadership Principles @ Amazon Execution Is Binary We #GetShiftDone. We take immense pride in both the quality of our work and our relentless determination to deliver on our commitments. If we say we are going to do something, we do it. We own the outcome with an unstoppable mindset through the finish line and are impatient to move the ball forward. This means we work really hard, execute with urgency, and ruthlessly challenge timelines for anything important. As a result, we do not defer responsibility to other teams or individuals. Instead, we take the problem as far as we can and only when needed ask others for help. Each time a crisis or opportunity emerges we take the hill as one team, because we are allergic to the words “it can't be done” . Missionaries, Not Mercenaries We before me. We believe in our mission to build a better world for workers. We understand why our work matters and take seriously how it impacts our customers and our partners. This belief permeates everything we do from the strategic to the mundane. We are energetic, ambitious, and want to win. We constantly raise the standards for ourselves and everyone around us. We show up for our customers, our partners, and most importantly our teammates, and make every effort to build lasting relationships with each of them. We do not measure success based on our titles or the size of our empires. This also means we put the needs of the business before the details of our job descriptions. Rather than fight for a bigger piece of the pie, we fight to grow the entire thing and recognize this is how to grow our careers too. Inputs > Outcomes We work really hard. Fundamentally changing how labor works is not easy. It often requires long days, late nights, and weekends to deliver on our commitments. We lean into this challenge. We focus on the process. We think in terms of value chains and appreciate that a bad process with a good outcome is simply dumb luck. We lead with data. We use facts, not fiction, to build narratives and make decisions. To do this we prepare written memos in advance and resist the urge to engage in endless water cooler what ifs, because we value the time and attention of our teammates. We hire and develop the best. When we decide to hire a new team member, we do so because we believe they will increase the talent density on our team. We view ourselves as leverage maximizers rather than inconvenience reducers and strive to increase the output of everyone we interact with. Honesty Over Harmony We share the truth even when it is painful. We do not, however, share the truth callously to hurt people's feelings or make them look bad. We also assume positive intent. If someone is not delivering in a way that we need, we ask them and tell them before assuming the worst. We embrace mutual feedback. As people leaders we care more about our team's growth and success than how much others like us. As individuals we seek, accept, and apply feedback. We do not give or take feedback personally because we understand it enables us to learn and grow. We tell the truth to ourselves. We reject a pollyannaish view of our world. Instead if something isn't going well that we are responsible for, we call it out. And when someone calls out their own truth that may be less optimal, we don't punish them for it. We have the meeting in the meeting. If something is broken or we disagree, we call it out and say something in the moment even if it feels uncomfortable to do so. This means that if something is broken, we do not just accept it and complain later. Invent & Iterate We are ********************* categorically reject the phrase “that is how it's always been done” , and constantly discover new and better ways to do more with less. This means we are resourceful and often do things that don't scale, only to create ways to scale them later. We're builders. We think BIG. At every level of the company, we embrace big, hairy, audacious, and transformative goals. We fear lack of progress and incremental thinking more than failing to deliver or falling short of an audacious goal. We believe courage means to try without fear and learn without ego. We do not let perfect get in the way of better. When faced with the choice we prioritize delivering something, even if imperfect, over endless debate and alignment. We embrace good mistakes.
    $58k-101k yearly est. Auto-Apply 56d ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claims representative job in New Brunswick, NJ

    At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
    $53k-67k yearly est. Auto-Apply 38d ago
  • Billing/Claims Specialist

    P4P

    Claims representative job in New York, NY

    Location: Brooklyn, NY Salary: $52K-$80K The Billing and Claims Specialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials. Key Responsibilities for Billing/Claims Specialist: Billing & Claims Processing Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance Review authorizations, service hours, and eligibility prior to billing Ensure accurate coding and claim data in accordance with payer guidelines Process electronic and paper claims as required by payers Claims Follow-Up & Reconciliation Monitor claim status and follow up on unpaid, denied, or underpaid claims Investigate and resolve billing discrepancies and denials Submit corrected or resubmitted claims as needed Post payments, adjustments, and denials accurately into billing systems Reconcile remittance advice (EOBs/ERAs) with billed claims Authorization & Compliance Track MLTC authorizations, service limits, and expiration dates Ensure billing aligns with approved care plans and service authorizations Maintain compliance with Medicaid, MLTC, and insurance regulations Stay current on payer rule changes and billing requirements Qualifications for Billing/Claims Specialist: Required Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting Hands-on experience with MLTC billing and insurance claims Strong knowledge of Medicaid and managed care billing processes Proficiency with home care billing software and clearinghouses Excellent attention to detail and organizational skills
    $52k-80k yearly 6d ago
  • Transactional Risk Claims Specialist

    Howden Group Holdings Ltd.

    Claims representative job in New York, NY

    Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden. * Classification: Exempt/Full-time * Reports to: Head of Claims for Transactional Risk * Travel: 0-15% * Salary: $150,000.00-$215,000.00 Role overview DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team. The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice. This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time. Role responsibilities * Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion. * Assist with entering claim data into operational systems. * Assist with quality control and performance management, to ensure high-quality claim handling. * Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers. * Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices. * Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners. * Perform other duties as assigned. Key requirements * Bachelor's degree required and law degree preferred. * Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable. * Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions. * Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives. * Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint). * Ability to manage multiple competing priorities. * Ability to adapt to evolving regulatory and legal environments. * Complete assigned tasks correctly, on time and able to learn quickly. * Self-motivated and demonstrating attention to detail. * Be able to work independently for extended periods. * Excellent written and verbal communication skills as well as general business understanding. * Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment. * If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team. What do we offer in return? A career that you define. Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more. What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community. Our culture: people first Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world. The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key. Diversity and inclusion At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances. What do we offer in return? A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us: * Our successes have all come from someone brave enough to try something new * We support each other in the small everyday moments and the bigger challenges * We are determined to make a positive difference at work and beyond Reasonable adjustments We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*. If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require. * Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more. Permanent
    $43k-77k yearly est. Auto-Apply 40d ago
  • Complex Claims Specialist-MPL

    Hiscox

    Claims representative job in New York, NY

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

    Hyperiongrp

    Claims representative job in New York, NY

    Who are we? Howden is a global insurance group with employee ownership at its heart. Together, we have pushed the boundaries of insurance. We are united by a shared passion and no-limits mindset, and our strength lies in our ability to collaborate as a powerful international team comprised of 23,000 employees spanning over 56 countries. People join Howden for many different reasons, but they stay for the same one: our culture. It's what sets us apart, and the reason our employees have been turning down headhunters for years. Whatever your priorities - work / life balance, career progression, sustainability, volunteering - you'll find like-minded people driving change at Howden. Classification: Exempt/Full-time Reports to: Head of Claims for Transactional Risk Travel: 0-15% Salary: $150,000.00-$215,000.00 Role overview DUAL North America is seeking a Transactional Risk Claims Specialist for the Claims team. The Transactional Risk Claims Specialist role will support the Head of Claims for Transactional Risk in the management of claims under Representations & Warranties Insurance (RWI) policies. Private equity and strategic buyers in M&A deals seek policies to protect them from risk on the target companies they acquire. This role encompasses assisting the Head of Claims with substantive claim handling, along with data entry and electronic file organization-type tasks to support the RWI practice. This position anticipates an approximate 65/35 split between substantive claim handling and electronic organization-type responsibilities, respectively, to start. This position is intended to provide the ability to grow within the role, including to assume greater responsibility over time. Role responsibilities Assist the Head of Claims for Transactional Risk in the end-to-end claims management process for RWI claims, from claim notice to conclusion. Assist with entering claim data into operational systems. Assist with quality control and performance management, to ensure high-quality claim handling. Collaborate with a variety of constituents including underwriters, carrier partners, and advisors, to address complex claim issues and foster strong relationships with carrier partners and brokers. Assist with the development and implementation of strategic initiatives to optimize claims processes and enhance operational efficiency by leveraging data analytics, industry trends, and best practices. Enforce compliance standards and uphold regulatory requirements, internal controls, and service level agreements with carrier partners. Perform other duties as assigned. Key requirements Bachelor's degree required and law degree preferred. Minimum of 2 years of experience in insurance claims handling. Prior experience with RWI policies is strongly desirable. Familiarity with contract law and relevant legal principles related to insurance claims, particularly in the context of mergers and acquisitions. Demonstrated ability to develop and execute strategic plans, in both the context of individual claims and broader operational initiatives. Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint). Ability to manage multiple competing priorities. Ability to adapt to evolving regulatory and legal environments. Complete assigned tasks correctly, on time and able to learn quickly. Self-motivated and demonstrating attention to detail. Be able to work independently for extended periods. Excellent written and verbal communication skills as well as general business understanding. Must be able to remain in a stationary position 50% of the time, with occasional movement in the office (if applicable) to access cabinets and equipment. If you do not meet all the qualifications for this role, we still encourage you to apply, as we are always looking for diverse talent to join our growing team. What do we offer in return? A career that you define. Yes, we offer all the usual rewards and benefits - including medical, dental, vision, a wide variety of wellbeing offers, competitive salary, unlimited PTO, 401k with company match, paid volunteer days and more. What you might not expect is a job where everyone has a voice, where volunteering in the community is part of the day job, and where everyone is encouraged to play a part towards our sustainability goals. We want people who want to make a difference - not just in the workplace, but in the industry and in the wider community. Our culture: people first Our core values dictate how we live and work. We're a group with independence and people at its heart and we're a home for talent with a unique culture: the biggest small company in the world. The focus on being a people-first business has always been at the very heart of the group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it. And finding the most talented and entrepreneurial people to join the group has been and will continue to be key. Diversity and inclusion At DUAL, we consider our people our chief competitive advantage and, as such, we treat colleagues, candidates, clients and business partners with equality, fairness and respect, regardless of their age, disability, race, religion or belief, gender, sexual orientation, marital status or family circumstances. What do we offer in return? A career that you define. At Howden, we value diversity - there is no one Howden type. Instead, we're looking for individuals who share the same values as us: Our successes have all come from someone brave enough to try something new We support each other in the small everyday moments and the bigger challenges We are determined to make a positive difference at work and beyond Reasonable adjustments We're committed to providing reasonable accommodations at Howden to ensure that our positions align well with your needs. Besides the usual adjustments such as software, IT, and office setups, we can also accommodate other changes such as flexible hours* or hybrid working*. If you're excited by this role but have some doubts about whether it's the right fit for you, send us your application - if your profile fits the role's criteria, we will be in touch to assist in helping to get you set up with any reasonable adjustments you may require. *Not all positions can accommodate changes to working hours or locations. Reach out to your Recruitment Partner if you want to know more. Permanent
    $43k-77k yearly est. Auto-Apply 42d ago
  • Claims Specialist

    Sourcepro Search

    Claims representative job in New York, NY

    SourceProSearch is seeking a Claims Specialist with 1-2 years of experience to work in our New York office. The ideal candidate should be comfortable with technology and platforms. This position requires at least 2 days per week in the office. Job Responsibilities: Format documents and communications for clients. Liaise between third-party vendors and the firm. Review documents (release/document verification) for production to defense counsel for quality control. Calendaring and entry of case info into the database. Perform intake and initial filtering of client inquiries. Preparation of submissions involving large volumes of individual claims. Run and analyze client data reports. Organize documents and communications with clients. Ensure that case documents accurately reflect a client's individual information. Keep track of communications or developments relating to client cases and deadlines that may be applicable to individual clients. Prepare and send client communications. Communicate with clients telephonically, on occasion. Work with attorneys to plan data gathering and settlement update workflows. Analyze and summarize client inquiries to identify trends and patterns requiring further action. Assist with the development of processes and technological systems for addressing large volumes of client interactions. Skills/Requirements: Proficient in the use of Microsoft Word and Excel. Familiarity with Filesite preferred. Familiarity with client management systems or databases preferred. Strong technical skills and ability to quickly learn new litigation support software. Strong written and oral communication skills and strong interpersonal skills. Must possess great attention to detail. Must possess analytical and critical thinking skills. Strong organizational and time-management skills. Ability to work independently while understanding the importance of teamwork. Ability to manage workload consisting of multiple tasks. The work shift for this position is 9:30 am-5:30 pm, five days a week, but the applicant must be willing and available to work overtime, both evening and weekends, when necessary. ****************************
    $43k-77k yearly est. 60d+ ago
  • Claims Specialist 3- Staffing

    Circet USA

    Claims representative job in Englewood Cliffs, NJ

    Job Description Circet USA is the leading provider of Network Services in North America, and we're looking for talented professionals to join our team. We specialize in engineering and construction services delivering comprehensive solutions across Inside Plant, Outside Plant, and Wireless networks to meet the evolving infrastructure needs of our customers. With nearly 50 years of industry experience, we work with major telecom service providers, MSOs, cloud service providers, and utilities. At Circet USA, you'll have the opportunity to make an impact by helping to create customized solutions that address our clients' unique challenges. If you're passionate about innovation and thrive in a dynamic environment, we'd love to hear from you. Circet USA's benefits package includes the following: Medical, Dental, and Vision insurance Digital Health & Wellness Support Critical Illness, Accident, & Hospital Insurance Short-term & Long-term disability Group term & Voluntary life insurance Flexible Spending and Health Savings Accounts Paid Time Off & 401K Company Discount Website Responsibilities We are seeking a highly skilled and experienced Claims Specialist 3 to fulfill a staff augmentation role with Circet USA's customer. The primary objective of the Claims Specialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management. The goal of the Claims Specialist is to support the Product Safety Team by handling Claims with professionalism, care and urgency, making sure claims are reported and being handled in a timely manner. To achieve the highest performance, the person in this position is expected to maintain effective and timely communication with key customers, claims adjusters, stakeholders and leaders within the department, team, and cross-department where applicable. ESSENTIAL DUTIES & RESPONSIBILITIES include the following. Other duties may be assigned: Collaborate with team members in the Product Safety department, PL Insurance Carrier, outside law firm and 3rd Party administrators. Generate daily/weekly/monthly reports, with analysis and recommendations Manage 4-7 ongoing and ad-hoc projects that may include KPIs and Metrics Ensure that all projects have required documentation as they move through the project tollgates Communicate to Product Liability leadership on project status and escalation/decision points Works cross functionally with HQ teams in Korea (occasional evening conference call) and SEA operations to manage all possible risks. Pending Claim Management, KPI & TAT Management - Claim registration to closure Product Verification Liability Assessment by reviewing diagnosis results Reporting on high-profile claims to the leadership Qualifications Bachelor's Degree (or equivalent experience) 3-5 years of hands-on claims management & customer care experience Expertise in MS, Excel, and PPT Proven capability to analyze data and develop a course of action Proven ability to prioritize and manage multiple projects, meet deadlines and drive to resolution Process, procedure, strategic planning and project development experience Experience working with and influencing cross-functional teams. Experience working within the insurance and/or home appliance industry a plus Experience with product development or testing a plus Experience working in a complex and wide organization and department Claims Adjuster License a plus Takes project ownership and possess leadership qualities with an entrepreneurial approach Circet USA is an Equal Opportunity Employer - Veteran/Disabled. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by law.
    $44k-79k yearly est. 22d ago
  • Claims Specialist

    Sales Match

    Claims representative job in Newark, NJ

    Job Title: Remote Claims Specialist Hourly Pay: $22 -$27/hour We are looking for a skilled Claims Specialist to join our work-from-home team. In this role, you will assist in processing and reviewing insurance claims, ensuring all necessary information is gathered, and helping resolve claims efficiently. If you have strong attention to detail and enjoy supporting customers through the claims process, this is a great opportunity for you. Key Responsibilities: Assist in processing insurance claims, ensuring accuracy and timely resolution Review claims documentation, including reports, medical records, and other evidence Communicate with claimants, insurance adjusters, and third parties to gather information Help resolve disputes or issues with claims and escalate when necessary Maintain detailed records of claims progress and updates Ensure compliance with industry regulations and internal policies Provide excellent customer service and answer inquiries related to claims Qualifications: Experience in insurance, claims handling, or a related field Strong attention to detail and organizational skills Excellent communication and customer service abilities Ability to handle multiple claims and prioritize effectively in a remote environment Familiarity with insurance policies and claims procedures is a plus Must have reliable internet and a quiet, dedicated workspace Perks & Benefits: 100% remote work flexibility Competitive hourly pay: $22 - $27 Paid training and professional development opportunities Flexible work hours, including evening and weekend options Opportunities for career growth in the insurance industry A supportive and team-oriented work environment
    $22-27 hourly 60d+ ago
  • Billing/Claims Specialist

    P4P

    Claims representative job in New York, NY

    Job DescriptionLocation: Brooklyn, NY Salary: $52K-$80KThe Billing and Claims Specialist is responsible for managing all aspects of billing, claims submission, and reimbursement for a home care agency serving patients under MLTC (Managed Long Term Care) plans and other insurance providers. This role ensures accurate and timely billing, compliance with payer requirements, and effective follow-up on claims to maximize reimbursement and minimize denials.Key Responsibilities for Billing/Claims Specialist: Billing & Claims Processing Prepare, submit, and track claims for MLTC plans, Medicaid, Medicare (if applicable), and commercial insurance Review authorizations, service hours, and eligibility prior to billing Ensure accurate coding and claim data in accordance with payer guidelines Process electronic and paper claims as required by payers Claims Follow-Up & Reconciliation Monitor claim status and follow up on unpaid, denied, or underpaid claims Investigate and resolve billing discrepancies and denials Submit corrected or resubmitted claims as needed Post payments, adjustments, and denials accurately into billing systems Reconcile remittance advice (EOBs/ERAs) with billed claims Authorization & Compliance Track MLTC authorizations, service limits, and expiration dates Ensure billing aligns with approved care plans and service authorizations Maintain compliance with Medicaid, MLTC, and insurance regulations Stay current on payer rule changes and billing requirements Qualifications for Billing/Claims Specialist: Required Minimum 2-3 years of billing and claims experience in home care, healthcare, or related setting Hands-on experience with MLTC billing and insurance claims Strong knowledge of Medicaid and managed care billing processes Proficiency with home care billing software and clearinghouses Excellent attention to detail and organizational skills
    $52k-80k yearly 7d ago

Learn more about claims representative jobs

How much does a claims representative earn in West Caldwell, NJ?

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

Average claims representative salary in West Caldwell, NJ

$54,000

What are the biggest employers of Claims Representatives in West Caldwell, NJ?

The biggest employers of Claims Representatives in West Caldwell, NJ are:
  1. The Plymouth Rock Company Incorporated
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